Podiatry Coding & Billing Alert

Question: Would you clarify the difference between a simple and complex incision and drainage (10060 and 10061)? We are under the impression that the difference is determined by whether or not the podiatrist uses packing after the incision. Is this correct?

Georgia Subscriber

Answer: The need for packing may be correct for determining simple or complex I&D in some cases, but not in others. The description for code 10060 (Incision and drainage of abscess [e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia]; simple or single) includes clinical examples of a carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, paronychia, cyst, or furuncle. These are all simple, single, isolated small collections and rarely (but occasionally) require packing.

The more complex lesions (10061, ... complicated or multiple), will generally be larger. They may require packing, probing to break up loculations, or they may be a collection of more than one simple area. Any of these factors should indicate that the I&D warrants 10061.

Keep in mind: If documentation describes the I&D as "deep," or beyond the cutaneous layer, then other codes should be considered, such as 28002 (Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space).