ED Coding and Reimbursement Alert
Cyst Drainage Vs. Cyst Removal
Question: "Px with CC: growth, right cheek Exam shows cyst full of purulent yellow pus Dx: seborrheic keratosis Drained wound w/scalpel, saline irrigation, probed to break up loculations, septae broken down, curetted, and packed with gauze. Sent specimen to lab." We just got the lab results back, and the sample was negative for neoplasms. How do I code this encounter? Is this a biopsy or a separate service? Tennessee Subscriber Answer: Your physician performed an incision and drainage (I&D) of a sebaceous cyst with pathology. "Seborrheic keratosis" is the more clinical term for these cysts. On the claim report the following: • 10061 (Incision and drainage of abscess [e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia]; complicated or multiple) • the appropriate-level E/M service based on notes, such as 99282 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of low complexity ...) • modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) appended to the E/M to show that it was separate from the I&D • either 702.11 (Inflamed seborrheic keratosis) or 702.19 (Other seborrheic keratosis) appended to 10061 and the E/M to represent the cyst, depending on the specific type.
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Cyst Drainage Vs. Cyst Removal
Question: I need some help with the following operative note: "Px with CC: growth, right [...]
