tci Medicare Compliance & Reimbursement - 2010 Issue 15

Reader Questions: I&D Area Can Deflate 10060 Option

Question: Our physician performed a level-four E/M service in the emergency department for a patient and diagnosed a peritonsillar abscess. Notes indicate that the physician aspirated the abscess to confirm the presence of pus, and then incised and drained it. Is this a 10060 incision and drainage (I&D)?Answer: These types of abscesses have their own I&D codes. For this encounter you would report the following codes: • 42700 (Incision and drainage abscess; peritonsillar) for the I&D • 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components:...

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