How To Use CPT Code 10061

CPT 10061 refers to the incision and drainage of a complicated or multiple abscess, such as carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 10061.

1. What is CPT 10061?

CPT 10061 is a medical procedure code used to describe the incision and drainage of a complicated or multiple abscess. This code is specifically used for complex or severe cases that require more time and effort than a simple incision and drainage procedure.

2. 10061 CPT code description

The official description of CPT code 10061 is: “Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes a circumferential incision over the target area of abscess.
3. The incision is deepened through the vascular inner layer of skin and down to the deep level of the abscess cavity.
4. The provider opens the abscess and excises the inflamed fatty and dead tissues within the cavity.
5. The pus is drained completely from the abscess.
6. The wound may be left open for continuous discharge of fluids, and woven cotton cloth may be used to soak up fluids and blood.
7. A small surgical clamp may be used to break up any loculations within the cavity.
8. Gauze or other material may be inserted to pack the abscess cavity.
9. The procedure may be repeated for additional lesions if necessary.
10. Some lesions may require placement of a drain for continued drainage.

4. Qualifying circumstances

Patients eligible to receive CPT code 10061 services are those with a complicated or multiple abscess that requires more extensive incisions, drain placements, extensive packing, and a more complicated wound closure than a simple incision and drainage procedure. This code is not used for incision and drainage of pilonidal cysts, hematomas, foreign bodies, or wound infections.

5. When to use CPT code 10061

It is appropriate to bill the 10061 CPT code when the provider performs incision and drainage of a complicated or multiple abscess, such as carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia. This code should be used for complex or severe cases that require more time and effort than a simple incision and drainage procedure.

6. Documentation requirements

To support a claim for CPT 10061, the following information should be documented:

• Patient’s medical history and physical examination findings
• Indication for the procedure, including the type and location of the abscess
• Description of the procedure, including the incision, drainage, and wound closure techniques used
• Any complications encountered during the procedure
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 10061, it is essential to follow the specific guidelines and rules set by the payer. Some tips for billing this code include:

• Ensure that the documentation supports the use of CPT 10061, including the complexity of the procedure and the need for multiple incisions, drain placements, extensive packing, and a more complicated wound closure.
• Do not use CPT 10061 for simple or single incision and drainage procedures. Instead, use CPT 10060 for these cases.
• Do not use CPT 10061 for incision and drainage of pilonidal cysts, hematomas, foreign bodies, or wound infections. See codes 10080 to 10180 to report those services.

8. Historical information

CPT 10061 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 10061

Five similar codes to CPT 10061 and how they differentiate are:

1. CPT 10060: Used for simple or single incision and drainage of the same types of lesions as CPT 10061.
2. CPT 10080: Used for incision and drainage of a pilonidal cyst.
3. CPT 10140: Used for incision and drainage of a hematoma, seroma, or fluid collection.
4. CPT 10160: Used for puncture aspiration of an abscess, hematoma, bulla, or cyst.
5. CPT 10180: Used for incision and drainage of a postoperative wound infection.

10. Examples

Here are 10 detailed examples of CPT code 10061 procedures:

1. Incision and drainage of a complicated carbuncle on the back of the neck.
2. Incision and drainage of multiple cutaneous abscesses on the patient’s thigh.
3. Incision and drainage of a complicated furuncle on the patient’s buttock, requiring extensive packing and wound closure.
4. Incision and drainage of a suppurative hidradenitis on the patient’s axilla, with multiple incisions and drain placements.
5. Incision and drainage of a complicated paronychia on the patient’s finger, requiring a more complex wound closure.
6. Incision and drainage of multiple subcutaneous abscesses on the patient’s abdomen.
7. Incision and drainage of a complicated cyst on the patient’s face, requiring extensive packing and a more complicated wound closure.
8. Incision and drainage of a complicated furuncle on the patient’s leg, with multiple incisions and drain placements.
9. Incision and drainage of a suppurative hidradenitis on the patient’s groin, requiring extensive packing and wound closure.
10. Incision and drainage of multiple cutaneous abscesses on the patient’s arm, requiring a more complex wound closure.