# Incision and Drainage - toe cellulitis



## wickyq

Had a provider report an incision and drainage of a toe cellulitis (abscess).
On reading the note, she had used a 25g needle to "incise" the abscess.
Based on the size of the needle, my go-to 'supercoder' provider agreed that this puncture isn't an incision.  But she held that if a large gauge needle, say a 19 or 20 g was used and the abscess was drained, this would constitute an incision and drainage.  
I think that based on the definition of 'incision' as a cut with a sharp surgical instrument, the puncture by the large gauge needle still would not be sufficient to code a 10060 for the incision and drainage. Which is right? Large gauge needle puncture to drain an abscess justifies an I & D code -  yes or no


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## Mojo

I agree with you. A cut or incision (not puncture) with a large bore needle (18, 19 or 20 gauge) would justify an I&D of an abscess. A puncture does not allow access for the insertion of a hemostat or culture tips, permit adequate drainage or irrigation.


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## DeeCPC

You stated, "the definition of 'incision' as a cut with a sharp surgical instrument"   the needle is being used as a sharp surgical instrument that is incising not puncturing the skin and it creates a defect that is large enough to allow for drainage.  

We code the incision and drainage of an abcess with a large gauge needle as 10060.


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