CPT code 10060 is for the drainage of a skin abscess, a procedure to remove pus and relieve pressure from an infected area.
CPT code 10060 is used for the procedure involving the drainage of a skin abscess. This code is applied when a healthcare provider needs to make an incision to drain pus or fluid from an abscess, cyst, or other localized infection under the skin. This procedure helps to relieve pain, reduce swelling, and promote healing by removing the infected material.
For CPT code 10060, "Drainage of skin abscess," the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service. Use this modifier if an E/M service was provided in addition to the drainage procedure.
2. Modifier 50: Bilateral procedure. Use this modifier if the procedure was performed on both sides of the body.
3. Modifier 51: Multiple procedures. Use this modifier if multiple procedures were performed during the same session.
4. Modifier 52: Reduced services. Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
5. Modifier 58: Staged or related procedure or service by the same physician during the postoperative period. Use this modifier if the drainage is part of a planned, staged procedure.
6. Modifier 59: Distinct procedural service. Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
7. Modifier 76: Repeat procedure or service by the same physician. Use this modifier if the procedure was repeated by the same physician.
8. Modifier 77: Repeat procedure by another physician. Use this modifier if the procedure was repeated by a different physician.
9. Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period. Use this modifier if the patient had to return for an unplanned procedure related to the initial drainage.
10. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if the procedure was unrelated to the original procedure performed during the postoperative period.
11. Modifier LT: Left side. Use this modifier if the procedure was performed on the left side of the body.
12. Modifier RT: Right side. Use this modifier if the procedure was performed on the right side of the body.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 10060 is reimbursed by Medicare, but the reimbursement amount can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides the standard reimbursement rates for services covered under Medicare Part B, including CPT code 10060. However, the final reimbursement amount may also be influenced by the specific Medicare Administrative Contractor (MAC) that processes claims in your geographic region. Each MAC may have slight variations in how they interpret and apply the MPFS, so it's essential to consult with your local MAC for the most accurate and up-to-date information regarding reimbursement for CPT code 10060.
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