I&D vs Debridement

[cynthiag14]

Preop/Postop DX: Right small finger infection and open wound
Procedure: Right small finger debridement with irrigation and wound closure as well as local anesthetic
Indication: The patient presented to my office with a right small finger felon that was I&D in an urgent care. The wound continued to be problematic and there was ongoing infection and thus she was recommended to undergo surgical intervention. She understood the risks and benefits and elected to proceed.

"The wound was a longitudinal incision over the ulnar aspect of the small finger. Scissors were used to open up. There was some bit of fibrinous material, but no appreciable purulence. A scissor and rongeur were used to cut out and excise the fibrinous material, which was mostly deep dermal tissue and fat. The wound was then copiously irrigated and the tourniquet was released. The wound was closed using nylon and the patient was wrapped in sterile dressings. he was transferred to PACU stably."

Provider wants 10061 & 12001.. Please help as I am not sure if 11042 alone would be better. I don't have a ton of experience with I&D and debridement.

Thank you!

 

[cappa412]

This is Incision & Drainage.

In your CPT, index Abscess, Tissue, Finger. It will guide you to 26010, 26011.

"The patient presented to my office with a right small finger felon" points towards 26011 Drainage of finger abscess, complicated (e.g. felon).

"The wound was closed using nylon" simple repair, would bundle to 26011 so do not code.

To index the diagnosis, Abscess -> Finger (see abscess, hand) -> L02.511

26011-F9, Dx linkage L02.511

If a repeat procedure by the same department or provider, append modifier 58 to indicate it as a staged procedure.