May 20, 2022

Complicated defined for these codes? CPT 10060 includes a “simple” or “single” incision and drainage and 10061 features a “complicated” incision and drainage or “multiple” incision and drainages. The AMA addressed that question in their CPT Assist publication in December of 2006. The AMA said that the CPT handbook itself doesn’t present definitions for simple and difficult and that the code chosen is based on the physician’s judgment concerning the diploma of issue concerned in the incision and drainage procedure. This brings us to a different questions: how are simple. In order coders, how will we pull out that element from an operative report since we’re not the physician making that judgment? So what makes 10060 and 10061 completely different from one another? If we glance on the examples in parentheses in the descriptions for these codes in the CPT manual, we will see that an incision and drainage of a carbuncle, hidradenitis, a cyst, a furuncle, paronychia, and cutaneous and subcutaneous abscesses could be reported with these codes.

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