Wondering how to code this I&D of a foot abscess. Cannot use 11044 due to LCD. Was wondering if I can use 28002. Thanks for any help!
Fifteen blade was used to make an incision through the skin and subcutaneous tissue. Abscess cavity was identified. Purulent drainage noted. Cultures obtained. Curette was used to debride the abscess cavity. Area of the necrotic skin was also evaluated. necrotic skin was resected from dorsal part of the foot using a 15 blade.. Abscess cavity was noted. Curette was used to debride the purulent an abscess, muscle fascia extensor tendon a curette was used to debridement of the tarsal bone was copiously irrigated.
Which MAC or LCA are you referring to? What's your DX? Was this performed in the office, IP, OP, or ASC?
Some of the LCA's for Wound Care and Debridement Services that are currently in effect do state that Surgical Debridement codes "11042-11047 is not appropriate for incision and drainage of abscess including paronychia" and "Removal of devitalized tissue from wound(s), non - selective debridement, without anesthesia" are considered part of active wound care management, and are not considered as debridement. The WPS LCA for Wound Care lists Cutaneous abscess ICD-10 codes as medically necessary. However, 11042 defined as “debridement, subcutaneous tissue” should be used if only necrotic subcutaneous tissue is debrided, even though the ulcer or wound might extend to the bone, so 11044 would not be appropriate for excising a cutaneous abscess of a WOUND or ULCER. Noridian's LCA does consider Cellulitis medically necessary, but not for the foot.
Additionally, debridement codes require documentation of the total size/surface area and depth of the tissue that was surgically removed. I don't see that documented in the documentation you included.
28001-28003 is I&D of the bursa/bursal space, which is not supported by the documentation. And 28002 requires that the incision is made through the skin AND fascia, only a curette was used.
The most appropriate code to use would be 10060 - Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single OR 10061 - Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple. For these codes "The abscess or cyst is opened with a surgical instrument, allowing the contents to drain. The lesion may be CURETTED and irrigated."