Incision and Drainage
Incision and Drainage (I&D)
Incision & Drainage is medical procedure is to treat abscess, cyst, Hematoma, Seroma, carbuncle, or common localized infections. It involves making a small incision in the skin to allow the pus or fluid to drain out, relieving pressure and promoting healing.
Certain definitions:
Abscess: Pus filled cavity is called abscess. Paronychia: Paronychia is an infection of the skin around a fingernail or toenail.
Cyst: Abnormal fluid cavity is called cyst. While the word "cyst" when used as root word is considered to be addressed to urinary bladder, example cystitis is inflammation of urinary bladder.
Hematoma: Collection of blood outside the blood vessel is called hematoma. Collection of blood clot inside the blood vessel called thrombosis or embolism. Localized blood clot inside the blood vessel is called thrombosis whereas moving blood clot or clot has been moved from other location is called embolism
Seroma: A seroma is a collection of serous fluid that can occur under the skin, typically at a surgical site or in a location where tissue has been disrupted or removed. Serous fluid is a pale yellow, transparent fluid that is produced by tissues in response to injury or inflammation. Seromas are usually not dangerous, but they can cause discomfort, swelling, and increased risk of infection if not properly managed.
The I&D Codes are selected by considering the following factors in mind
Site
Type of removal
Simple or Complex
Based on the sites, there are different CPT codes available
Integumentary system:
I&D of skin: There are 2 codes for this. 10060 and 10061.
10060: Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single.
10061: Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple
When is it called complex?
Multiple Abscesses: If the patient has multiple abscesses that require drainage or more than abscess is coded with 10061.
Complex Abscesses: If the abscess is large, deep, or involves extensive tissue damage, 10061 would be used to indicate the complexity of the procedure.
Complications: If there are complications during the I&D procedure, such as the need for additional incisions, extensive debridement, or drain placement, 10061 would be used.
Provider's Documentation: If the provider's documentation specifies that the I&D procedure was complex or involved multiple abscesses, 10061 would be the appropriate code to use.
Pilonidal Cyst:
Incision and Drainage of pilonidal cyst is coded with 10080 or 10081.
10080: Simple, single incision and drainage of a single, uncomplicated pilonidal cyst.
10081: Complex, requiring extra time and technique, possibly involving drain placement, more extensive packing, or subsequent wound closure for a complicated pilonidal cyst.
Finger Abscess
26010: Drainage of a finger abscess; simple or single. This code is used for the incision and drainage of a single, uncomplicated abscess on the finger.
26011: Drainage of a finger abscess; complicated or multiple. This code is used for draining a more complex or multiple abscesses on the finger. Complicated I&D procedure in
Dentoalveolar Abscess
41800: Drainage of abscess, cyst, hematoma from dentoalveolar structures. Incision is made at the root of the tooth to reach to reach the abscess, hematoma, or cyst and is allowed it to drain. Drain may be used to help to remove the abscess, hematoma, or cyst.
Bartholin's gland Abscess
56420: Incision and drainage of Bartholin's gland abscess. Bartholin's gland is gland present on either side of the vagina.
Vulva or Perineum Abscess
56405: Incision and drainage of vulva or perineal abscess. Perinium is the area between the vagina and Anus in female and between the scrotum and anus in male.
Anorectal area
46040: Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure).