ED Coding and Reimbursement Alert

Reader Question:

When Substance Drained Is Incidental

Question: A physician performed electrocautery of a subungual abscess, but I can find a code only for electro-cautery of a subungual hematoma. I cannot find any generic codes for electrocautery. Do I have to include this procedure in the E/M code? Washington, D.C., Subscriber Answer: No, do not include the procedure in your E/M code. In fact, you should report the subungual hematoma code, 11740 (Evacuation of subungual hematoma). This procedure typically requires an electro-cautery pen to pierce the nail and drain blood. The code describes drainage of blood, as it is most common to drain blood with that clinical scenario. That you drained purulent material instead is only incidental. The code reports drainage, not the type of fluid, and represents a separate and distinct service.
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