How To Use CPT Code 26991

CPT 26991 describes the procedure of incision and drainage for an infected bursa in the pelvis or hip joint area. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26991?

CPT 26991 is used to describe the incision and drainage procedure performed by a healthcare provider to drain pus from an infected bursa in the pelvis or hip joint area. This code is used when the provider makes an incision in the skin, exposes the bursa, and drains the pus to alleviate the infection.

2. Official Description

The official description of CPT code 26991 is: ‘Incision and drainage, pelvis or hip joint area; infected bursa.’

3. Procedure

1. The healthcare provider prepares and anesthetizes the patient appropriately for the procedure.
2. The provider makes an incision in the skin over the infected bursa in the pelvis or hip joint area.
3. Once the bursa is exposed, the provider incises the lesion and presses around the area to ensure complete drainage of the pus.
4. The wound is thoroughly cleansed with saline solution.
5. The provider repairs the wound in layers using sutures.
6. A drain may be placed if there is a need for further pus drainage, or the site may be left open for continued drainage.
7. The wound site is covered with gauze after irrigation with an antibiotic.

4. Qualifying circumstances

CPT 26991 is performed when a patient has an infected bursa in the pelvis or hip joint area that requires drainage. The procedure is typically performed by a healthcare provider who is trained and qualified to perform incision and drainage procedures. The patient must be appropriately prepped and anesthetized before the procedure.

5. When to use CPT code 26991

CPT code 26991 should be used when a healthcare provider performs the incision and drainage procedure on an infected bursa in the pelvis or hip joint area. This code is not appropriate for other locations or types of incision and drainage procedures.

6. Documentation requirements

To support a claim for CPT 26991, the healthcare provider must document the following information:

• Patient’s diagnosis of an infected bursa in the pelvis or hip joint area
• Details of the procedure, including the incision made and the drainage performed
• Use of any antibiotics or saline solution during the procedure
• Repair of the wound with sutures
• Placement of a drain, if applicable
• Any additional instructions or follow-up care provided to the patient

7. Billing guidelines

When billing for CPT 26991, ensure that the procedure is performed on an infected bursa in the pelvis or hip joint area. It is important to follow the appropriate coding guidelines and use the correct modifiers, if applicable. Report CPT 26991 separately and do not report it with other codes unless there are specific circumstances that warrant additional codes.

8. Historical information

CPT 26991 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 on an infected bursa in the pelvis of a patient.
2. During the procedure, the provider makes an incision in the skin over the hip joint area to drain the pus from an infected bursa.
3. A patient with an infected bursa in the pelvis undergoes an incision and drainage procedure performed by a healthcare provider.
4. The healthcare provider performs an incision and drainage procedure on an infected bursa in the hip joint area of a patient.
5. A provider makes an incision in the skin over an infected bursa in the pelvis and drains the pus during a procedure.
6. An incision and drainage procedure is performed by a healthcare provider on an infected bursa in the hip joint area of a patient.
7. A patient undergoes an incision and drainage procedure on an infected bursa in the pelvis, performed by a healthcare provider.
8. The healthcare provider makes an incision in the skin over the hip joint area and drains the pus from an infected bursa during a procedure.
9. An infected bursa in the pelvis is treated with an incision and drainage procedure performed by a healthcare provider.
10. A healthcare provider performs an incision and drainage procedure on an infected bursa in the hip joint area of a patient.