Wiki CPT 10060 with no incision

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jvargocpc

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Can my provider still charge 10060 even if he didn't make an incision to drain the abscess?

He states, "They were not draining, but I was able to express pus by applying pressure from the abscesses without an incision"

Any idea where I can find something in writing for backup? Thanks!
 
This would not meet the definition of incision and drainage.

Both components must be performed to meet the criteria for selecting this code. Part of the work components RVUs are for the act of making the incision (scalpel, needle, lancet).

Removal of the material would be factored into in any E/M billed, since there is no CPT that represents just the drainage of material from a cyst (without incision)
 
ellzeycoding said:
This would not meet the definition of incision and drainage.

Both components must be performed to meet the criteria for selecting this code. Part of the work components RVUs are for the act of making the incision (scalpel, needle, lancet).

Removal of the material would be factored into in any E/M billed, since there is no CPT that represents just the drainage of material from a cyst (without incision)
Click to expand...

What if he used modifier 52?
 
No, he cannot bill 10060 as it was only squeezed although he can bill E/M only.

Only the below codes can be used in drainage without incision

For fine needle aspiration of abscess you can use-
  • 10021 Fine needle aspiration biopsy, without imaging guidance; first lesion
  • 10004 Fine needle aspiration biopsy, without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)
  • 10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion
  • 10006 Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)
  • 10007 Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion
  • 10008 Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)
  • 10009 Fine needle aspiration biopsy, including CT guidance; first lesion
  • 10010 Fine needle aspiration biopsy, including CT guidance; each additional lesion (List separately in addition to code for primary procedure)
  • 10011 Fine needle aspiration biopsy, including MR guidance; first lesion
  • 10012 Fine needle aspiration biopsy, including MR guidance; each additional lesion (List separately in addition to code for primary procedure)
For Puncture aspiration of abscess you can use-
10160 Puncture aspiration of the abscess, hematoma, bulla, or cyst
 
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