Wiki Claim denial 10060 for I&D sebaceous cyst

[cdawn711]

Hi,

I recently got a denial for a claim where a sebaceous cyst was drained from a patient's face (LT cheek). ICD-10 code was billed as L72.3 with CPT code 10060. I checked the LCD and L72.3 is not covered. The CPT index directly refers you to 10060 for I&D sebaceous cyst. The LCD doesn't even have unspecified cyst on the list and my provider does not feel abscess or cellulitis is appropriate. Has anyone else come across this?

Thanks,
Crystal

 

[cdawn711]

Answer

I found the answer in case anyone was curious. I queried the provider, an although her documentation clearly describes an I&D, what was actually done was an excision including the capsule- so an excision code should be used, not an I&D.