tci ED Coding & Reimbursement Alert - 2008 Issue 9

Reader Questions: Same Dx OK for Some Procedure-E/M Encounters

Question: A patient presents to the ED complaining of a new painful mass on his left shoulder blade. During the course of a level-two E/M, the physician diagnoses a single carbuncle, which he then incises and drains. How should I code this scenario? Maryland SubscriberAnswer: You should code separately for the E/M and I&D, but include the same diagnosis code for each CPT code. On the claim, report the following: - 10060 (Incision and drainage of abscess [e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia]; simple or single) for the I&D of...

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