Coding > Coding

10061

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oneround:
Check with your in-house there would be circumstances when you would, if pt cam in weekly and you billed monthly then the procedure would be billed as 1006x or 10061X.  Here is anohter example, look at 11200 and 11201.  If 3 tags were removed  It would be 11200 if 45 were removed it would be 11200 and 11201,11201,11201 or  11200 and11201 x3 form a coding aspect.  Also keep in mind that it depends on how your carrier wants you to bill the service.  Now back to 10061, Complicated or Multiple I wanna say runs in the the 100.00 payout range, so you tack a x4 on the baby you getting paid 400.00 but then again it could be that your carrier wants to know how many lesions are being abcessed.

ClaimCheck Clinical Edit Clarification
Inquiry:
Why is procedure 10061 disallowed when submitted more than the maximum
times allowed?
Code Description
10061
INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE,
SUPPURATIVE HIDRADENITIS, CUTANEOUS OR
SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR
PARONYCHIA); COMPLICATED OR MULTIPLE
Response:
Procedure 10061 is used to report incision and drainage of multiple or complicated
skin abscesses such as carbuncle, suppurative hidradentis, cutaneous or
subcutaneous abscess, cyst, furuncle, or paronychia. Typically, the operative site is
opened to drain, clean, and remove any infected or necrotic tissues.
A duplicate edit occurs when a procedure code description contains terminology that
does not warrant multiple submissions of that procedure for a single date of service.
This includes the following terms: Bilateral, Unilateral/bilateral, Single/multiple. A
Duplicate edit or review also occurs when a procedure is submitted multiple times,
exceeding the maximum allowance that would be clinically appropriate.
Per it's CPT descriptor, code 10061 represents the incision and drainage of
"complicated or multiple" abscesses. As multiple abscesses are assumed to occur at
separate sites on the skin or subcutaneous tissue, 10061 is appropriately reported
one time to represent the drainage of more than a single abscess.
Therefore, procedure 10061 is disallowed when submitted more than the maximum
times allowed.
Sources:
This edit is consistent with CPT coding guidelines.
Disclaimer:
Not for use or disclosure outside McKesson Information Solutions except under
written agreement.


Also;

ClaimCheck Clinical Edit Clarification
Inquiry:
Why is procedure 10060 disallowed when submitted with procedure 10061?
Code Description
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
Response:
Procedure 10061 is used to report incision and drainage of multiple or complicated
skin abscesses such as carbuncle, suppurative hidradentis, cutaneous or
subcutaneous abscess, cyst, furuncle, or paronychia. Typically, the operative site is
opened to drain, clean, and remove any infected or necrotic tissues.
Procedure 10060 is used to report the incision and drainage of a simple or single
abscess such as carbuncle, suppurative hidradenitis, cutaneous or subcutaneous
abscess, cyst, furuncle, or paronychia. The description of this procedure is not
specific to the site of the abscess.
CPT states that procedure 10060 represents single abscess drainage, while
procedure 10061 represents complicated or multiple abscesses. Thus, although
multiple abscesses would be located in separate anatomic locations, the procedure
for incision and drainage of more than one abscess, regardless of location, is
reported with 10061.
When similar or identical procedures are performed, but are qualified by an increased
level of complexity, only the definitive, or most comprehensive, service performed
should be reported. "Most Extensive Procedure" rationale as given in CMS' National
Correct Coding Policy Manual for Part B Medicare Carriers, p. IA-17 states "the
simple procedure is included in the complex procedure..." The reporting of both
represents overlap of service.
Therefore, procedure 10060 is not recommended for separate reimbursement when
submitted with procedure 10061.
Sources:
This edit is consistent with CMS coding guidelines.
This edit is consistent with the Correct Coding Initiative (CCI)

bliss:
Thanks again!
How about debridment code, or chemical exfoliation code.  Would like to bill for those also, not sure exactly if they can be billed with
99213,10061, & 10040.  Those are the codes that we use on a daily basis. 

oneround:
Billing debridments with I&D depends on body part and the depth because some of the incisions ar included in the debridments for example  27301 Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region - this code includes the incision and debriding of any necrotic tissue, per AAOS CodeX it states included in code 27301: "11. other incision and drainage (eg, 10060, 10061, 10140, 10160, 10180, 20000, 20005);  12. debridement"

There are dermabrasion codes in the 15780 series and also chemical exfoliation 17360. But if you are not meeting these descriptions it could just be part of the E/M service. If the provider feels that it was more than an E/M then you could look at the unlisted skin code.

bliss:
 :D  Wow thanks again, you have really helped with all these coding frustrations.  I may need some other info.  But for now I think I have received great info., and may be at peace.

Thanks,
again

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