tci Outpatient Facility Coding Alert - 2015 Issue 9

Coding Update: Use Musculoskeletal Codes for Deep Abscess I&D

Look beyond the skin section for coding abscess. When billing for abscess procedures, coders need to look beyond the integumentary (skin) section of the CPT® manual and use musculoskeletal codes when appropriate because these procedures reimburse at a higher rate than integumentary abscess codes. Sometimes, careful examination of the operative report may indicate that the surgeon went below the fascia into the muscle tissue and perhaps as far as the bone. Many coders overlook the musculoskeletal section because so much of their work is focused in the integumentary section of the manual (10000 series codes) or because the documentation...

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