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10061 Incision
I billed 2 units of this code along with e/m 99213. E/M was paid but 10061 was denied with a rejection code of 16 indicating info lacking, perhaps a remark code. The DX used for 10061 was 706.2. Is there others needed or perhaps modifiers?
Code 10061
Question--what makes this complicated?
Insertion of a drain or gauze that would require a follow-up visit within the ten day post-op period; infection; the size of the lesion; the need for culturing and, complexity of the dressing? The combination of any of these may substantiate the use of the more complicated code. Why 2 units, the code states, complicated or multiple. Use of these codes is not appropriate for treatment of blisters, cysts (including sebaceous cyst), or other fluid collections without the documented presence of discrete abscess, pus collection, pain, infection or inflammation
This code has limited diagnosis coverage, example: ICD-9-CM codes 681.10, 681.11, 682.7, and 709.8 only.