Ten-year-old boy has a painful felon abscess of the deep tissues of the palmar surface of his right thumb. The provider makes an incision on one side of the nail and then across the fingertip parallel to the end of the nail.
He identifies the area of abscess and drains it. A drainage tube is inserted.
What CPTand ICD-10-CM is reported?
Correct Answer: B
1. Procedure and CPTCode Selection:
The procedure involves an incision and drainage (I&D) of a deep abscess (felon) on the palmar surface of the right thumb. A felon is an abscess in the pulp of the fingertip, often involving deep tissue.
Code 26010 is specific for incision and drainage of a finger abscess, which includes the thumb. This code applies to cases where the abscess is drained from a deep tissue level.
Code 26011 is similar but involves the use of extensive drainage or debridement, which is not indicated in this case. Therefore, 26011 is not appropriate here.
Code 10061 refers to incision and drainage of abscesses at different locations on the body but not for specific areas such as the thumb, making it inappropriate in this context.
Code 10140 pertains to the evacuation of hematoma, seroma, or fluid but does not apply to abscesses, so it is not suitable for this scenario.
2. Modifier:
Modifier F5 is added to specify that the procedure was performed on the right thumb.
3. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code L02.511 is appropriate for cutaneous abscess of the right finger, as it accurately describes the diagnosis of a felon on the thumb.
L03.011 would represent cellulitis but does not specify an abscess, making it less precise for this case.
4. AAPC and CPTCoding Guidelines:
The AAPC guidelines for coding finger abscess drainage emphasize the selection of specific codes for deep tissue drainage procedures in extremities. Additionally, correct laterality should be included with the use of modifiers and specific ICD-10-CM codes for an accurate representation of the site and nature of the condition.
Thus, based on the coding standards and guidelines, the verified answer is B. 26010-F5, L02.511.