(2023) CPT 10060 & CPT 10061 | Descriptions & Billing Guidelines
CPT 10060 and CPT 10061 represent incision and drainage procedures of an abscess involving the skin, subcutaneous and/or accessory structures.
CPT 10061
Description of the 10061 CPT Code: Incision of a drainage of abscess (e.g. carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle or paronychia), complicated or multiple.
CPT 10060
Description of the 10060 CPT Code: Incision of a drainage of abscess (e.g. carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle or paronychia), simple or single.
How To Bill The 10060 CPT Code & 10061 CPT Code
If billing a covered diagnosis, the medical record must demonstrate that an abscess was present.
For example, if billing the diagnosis code for paronychia of the toe (ICD 10 CM code 681.11), the medical record must demonstrate that an abscessed paronychia was present and that incision and drainage of the purulent material occurred to bill procedure code CPT 10060 or CPT 10061.
If a nail avulsion occurred and the medical record documentation does not demonstrate that an abscess was present and incision and drainage of purulent material occurred, then the appropriate nail avulsion procedure code (CPT 11730 or CPT 11732) should be billed, not procedure codes CPT 10060 or CPT 10061.
Furthermore, this policy does not address many other anatomical sites of abscesses. Numerous incision and drainage procedure codes are specific to the incisions and drainage of an abscess in various anatomical sites.
Therefore, it would be appropriate to bill these more specific incision and drainage codes.
For example: an abscess of the eyelid should be billed with procedure code CPT 67700 (Blepharotomy, drainage of abscess, eyelid); a perirectal abscess should be billed with procedure code CPT 46040 (Incision and drainage of ischiorectal and/or perirectal abscess); an abscess of the finger should be billed with procedure codes CPT 26010 & CPT 26011 (Drainage of finger abscess).
