Following are some common mistakes pediatric practices make when reporting certain procedures. (The first article in this series, “Common Procedure Coding Faux Pas,” appeared in the August 2011 [volume 6, no. 11] AAP Pediatric Coding Newsletter™.)
Using Current Procedural Terminology (CPT®) code 12001 or 12011 (simple repair of superficial wounds; 2.5 cm or less)
CPT guidelines for reporting wound repair state that “wound closure utilizing adhesive strips as the sole repair material should be coded using the appropriate evaluation and management (E/M) code.” If adhesive strips are used in combination with sutures, staples, or tissue adhesives, the appropriate repair code (12001–13153) may be reported.
Using CPT code 10060 (incision and drainage of abscess; simple or single)
CPT code 10060 is reported when an incision is made and an abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, paronychia) is drained. Code 10161 (puncture aspiration...