General Surgery Coding Alert

Question: A patient had a left infected third branchial cleft cyst. The surgeon incised, drained, and took a culture specimen from fluctuant area. He debrided overlying skin that was necrotic and friable. The surgeon identified and removed keratinized debris from the cyst, then debrided and cauterized base of the abscess/cyst wall. Is this "incision and drainage" (10060) or is there a more comprehensive code for this work? Texas Subscriber Answer: The correct code for the procedure you describe is 42810 (Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues). A branchial cleft cyst is a congenital malformation that forms in the neck when the branchial cleft does not close as it should during embryonic development. Although often benign, the cyst may become infected and require removal. The most specific code to describe the procedure is 42810. Although the surgical report notes that the surgeon "incised and drained" [...]