How To Use CPT Code 23930

CPT code 23930 describes the procedure of incision and drainage for a deep abscess or hematoma in the upper arm or elbow area. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 23930?

CPT 23930 is a code used to describe the incision and drainage procedure performed by a healthcare provider to treat a deep abscess or hematoma in the upper arm or elbow area. This procedure involves making an incision to drain the accumulated pus or clotted blood in the deep structures of the affected area.

2. Official Description

The official description of CPT code 23930 is: ‘Incision and drainage, upper arm or elbow area deep abscess or hematoma.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The healthcare provider makes an incision over the abscess or hematoma area on the upper arm or elbow.
3. If the abscess or hematoma is deep, the provider may go down to the level of the bone.
4. The provider drains the abscess by squeezing or removes the clotted blood with the help of a sharp object in the case of a hematoma.
5. The wound is thoroughly cleansed and may be irrigated with an antibiotic solution.
6. A drain may be placed if there is a possibility of pus drainage in the future, or the wound is covered with gauze after irrigation.

4. Qualifying circumstances

CPT 23930 is used when a patient has a deep abscess or hematoma in the upper arm or elbow area that requires incision and drainage. An abscess is a swollen area within body tissue containing an accumulation of pus, while a hematoma is a solid swelling of clotted blood within the tissues. The procedure should be performed by a qualified healthcare provider.

5. When to use CPT code 23930

CPT code 23930 should be used when a healthcare provider performs the incision and drainage procedure for a deep abscess or hematoma in the upper arm or elbow area. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 23930, the healthcare provider must document the following information:

• Patient’s diagnosis of a deep abscess or hematoma in the upper arm or elbow area
• Details of the procedure, including the location of the incision and the depth of the abscess or hematoma
• Any additional procedures performed, such as irrigation or placement of a drain
• Post-procedure instructions or follow-up plans
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 23930, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, consider any specific billing requirements from insurance providers or payers.

8. Historical information

CPT 23930 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs an incision and drainage procedure for a deep abscess in the upper arm of a patient.
2. A patient presents with a hematoma in the elbow area, and a healthcare provider performs an incision and drainage procedure to remove the clotted blood.
3. A healthcare provider performs an incision and drainage procedure for a complicated deep abscess in the upper arm, requiring additional exploration and debridement.
4. A patient with a deep abscess in the elbow area undergoes an incision and drainage procedure, which includes exploration, debridement, and removal of a foreign body.
5. A healthcare provider performs an incision and drainage procedure for a deep abscess in the upper arm, which is complicated and requires exploration, debridement, and removal of foreign material.