# I&D



## samorn (Jul 23, 2009)

Hi 

Q: If a physician performs I&D simple one on each leg would it be appropriate to do 10060-rt, 10060-lt?  Or would CPT 10061 be appropriate because it's for multiple procedure?  I maybe over thinking.

TIA


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## halebill (Jul 24, 2009)

Legitimate question. Go with the definition _complicated or multiple_, report 10061. 10060 is on the CCI edits of itself, would bundle if reported twice.


Bill Hale, CPC


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## RebeccaWoodward* (Jul 24, 2009)

I agree with Bill.  CPT Assistant supports his statement.


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## dbarker (Sep 25, 2009)

*Another question about I&D*

Can someone look at this chart note and advise how it should be coded?  I had coded it as 10061  DX 682.3 and 11200  (MOD 59) DX 701.9.  Insurance company only paid on the 11200 and states that the other one is not payable because they can't be billed together??????   Any help on getting this paid would be really appreciated.  

Chief Complaint: I & D cyst, left axilla

Vital Signs 

Temperature: 97.6 degrees  F (oral)
Pulse rate: 70
Respirations: 20
Blood Pressure: 139/79 mm Hg




Brief Invasive Procedure Note

Date of procedure: *****
Time of procedure: 9.30
AM Diagnosis/indications: 1) Skin tags
2) 2 separate left axillary abscesses


Procedures 
Removal of Multiple left axilla skin tags
Other I&D of left axillary abscesses
Description of procedures: The skin was disinfected with alcohol swabs, analgesia was obtained with 2% lidocaine with epinephrine by infiltration. Betadine swabs were applied around the masses and skin tags
First, the skin tags, total of 7 in all, were excised individually by sharp dissection and bleeding was controlled with electrocautery.

The larger, left axilla abscess was incised with #11 blade with discharge of large amount of malodorous cheesy, bloody / purulent material. The abscess was explored and adhesions broken. This mass was noted to be made up of multiple other nodules. It was determined to be a complex abscess. Culture was obtained. The second abscess was likewise incised and the entire sac wall was extracted intact. The abscesses were both packed with strings of iodoform gauze. 

Antibiotic ointments were applied to the sites of skin tag excision. Dressing was applied. Pt tolerated the procedure well without complications. Pt was instructed on wound care. May remove repacking in 48 hrs but should replace wet gauze as often as necessary.  Pt was instructed to remove the gauze packing after 48hrs and to call with any questions. He will need to see a surgeon for a complete excision of the rest of the left axilla nodules

Physician(s):  
Assistant(s):  




Injections given and recorded during this visit 
LIDOCAINE-EPINEPHRINE 2-1:100000 % SOLN (LIDOCAINE-EPINEPHRINE) 1 cc by


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## FTessaBartels (Sep 25, 2009)

*Appeal with note*

I would appeal with the note. You clearly have two different procedures. 

F Tessa Bartels, CPC, CEMC


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## mkj2486 (Sep 26, 2009)

It looks like you didn't put modifier 59 on 10060.  Per CCI these codes do bundle, but a modifier is allowed.  I would add the modifier and send notes.


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## BURNS07 (Sep 27, 2009)

Hi
 codes 10060 and 10061 are dermatology codes, so you can never use anatomical modifiers with them(ft, lt). What you can do to show that it is different leg, but same type of procedure, use modifier 50 ( bilateral). So answer would be 10060 50 *1


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## BURNS07 (Sep 27, 2009)

For me it looks like that you are missing modifier 51 on 11200. In this case, when you have same site and two different procedures, after coding primary procedure, on the additional procedure or service that was provided on the same day, by the same provider, you use modifier 51, after 59 i would code as  10061
                            11200 59, 51


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