Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
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tci ED Coding & Reimbursement Alert - 2004 Issue 11
Reader Question: Report E/M for Repeat Drainage
Question: The emergency department physician had performed an incision and drainage procedure on a patient who returned to the ED two days later. At this visit, the physician reopened the abscess, irrigated it, and replaced the wick. Is this a billable service?Washington, D.C., Subscriber
Answer: Yes, you can bill this service using an evaluation and management code (99281-99285). Usually, CPT bundles typical postoperative care - and the plain and simple removal of packing would constitute typical postoperative care. However, if the abscess requires additional work, such as repeat drainage, dissection, irrigation, or replacement of packing, then you...
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