Home Health ICD-9/ICD-10 Alert

Question: I'm confused about coding for abscesses. Is it true that the Centers for Medicare & Medicaid Services (CMS) doesn't consider an incision and drainage of an abscess to be a surgical wound? What if the abscess has been excised? How would I code for an abscess in these different scenarios?


Oklahoma Subscriber

Answer: It's true that CMS doesn't consider the incision and drainage (I&D) of an abscess to be a surgical wound. However, if the abscess is excised or a surgical drain is placed, the incision may be considered a surgical wound. In these cases, the treatment changes the basic nature of the wound.

If the abscess still exists and there are signs and symptoms of infection, then you can code for the abscess. For example, if your patient is receiving Gentamicin for cellulitis in the wound after having an I&D for an abscess on her foot, you could report 682.7 (Other cellulitis and abscess; foot, except toes).

But, if a procedure was performed and the abscess is now "clean," you should use a surgical aftercare code such as V58.77 (Aftercare following surgery of the skin and subcutaneous tissue, NEC).