How To Use CPT Code 26011

CPT 26011 describes the procedure for draining a finger abscess, specifically a complicated abscess such as a felon. 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 26011?

CPT 26011 is used to describe the drainage of a finger abscess, particularly a complicated abscess like a felon. This code is used when a healthcare provider performs a procedure to drain the abscess and potentially insert a drainage tube. It is important to note that this code specifically applies to abscesses on the finger.

2. Official Description

The official description of CPT code 26011 is: ‘Drainage of finger abscess; complicated (e.g., felon).’ This code is part of the Incision Procedures on the Hand and Fingers range, which includes codes 26010-26080.

3. Procedure

1. The patient is prepped and anesthetized to ensure comfort during the procedure.
2. The healthcare provider makes a lateral incision along one side of the nail and then across the fingertip, parallel to the end of the nail.
3. Using this incision, the provider identifies the area of the abscess and proceeds to drain it.
4. After draining the abscess, the healthcare provider may choose to insert a drainage tube if necessary.

4. Qualifying circumstances

CPT 26011 is used for draining complicated finger abscesses, such as felons. It is important to note that this code specifically applies to abscesses on the finger. The healthcare provider must assess the patient’s condition and determine the need for drainage. The abscess must be considered complicated, requiring the expertise of a healthcare professional to perform the procedure.

5. When to use CPT code 26011

CPT code 26011 should be used when a healthcare provider performs a procedure to drain a complicated finger abscess, such as a felon. It is important to ensure that the abscess meets the criteria for a complicated abscess and that the procedure is performed on the finger. If the abscess is located on a different part of the body, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 26011, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for abscess drainage
• Details of the procedure, including the incision location and size
• Whether a drainage tube was inserted
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26011, ensure that the procedure meets the criteria for a complicated finger abscess. Use this code specifically for abscesses on the finger. It is important to follow the appropriate coding guidelines and ensure accurate documentation to support the claim.

8. Historical information

CPT 26011 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 drains a complicated finger abscess, known as a felon, for a patient who presents with severe pain and swelling.
2. During the procedure, a healthcare provider makes an incision along the side of the nail and across the fingertip to drain a complicated finger abscess.
3. A patient with a complicated finger abscess undergoes a drainage procedure performed by a healthcare provider to alleviate pain and promote healing.
4. A healthcare provider performs a procedure to drain a complicated finger abscess, known as a felon, for a patient who has developed an infection in the pulp of their fingertip.
5. Using CPT code 26011, a healthcare provider drains a complicated finger abscess, such as a felon, for a patient who requires immediate relief from pain and swelling.
6. A patient with a complicated finger abscess undergoes a drainage procedure performed by a healthcare provider to prevent further complications and promote healing.
7. A healthcare provider performs a procedure to drain a complicated finger abscess, known as a felon, for a patient who has developed an infection in the pulp of their fingertip.
8. Using CPT code 26011, a healthcare provider drains a complicated finger abscess, such as a felon, for a patient who requires immediate relief from pain and swelling.
9. A patient with a complicated finger abscess undergoes a drainage procedure performed by a healthcare provider to prevent further complications and promote healing.
10. A healthcare provider performs a procedure to drain a complicated finger abscess, known as a felon, for a patient who has developed an infection in the pulp of their fingertip.