CPT code 10060 , 10061 With ICD code

procedure code and description


10060- Drainage of skin abscess - average fee payment- $120 - $130


Coverage Indications, Limitations, and/or Medical Necessity

An abscess is a cavity containing pus surrounded by inflamed tissue. It is generally associated with pain, swelling and erythema. An abscess often requires incision and drainage to remove the purulent material in order for healing to occur.

Procedure codes 10060 and 10061 represent incision and drainage of an abscess involving the skin, subcutaneous and/or accessory structures. This includes the following types of abscess: furuncle, carbuncle, suppurative hidradenitis, an abscessed cyst, an abscessed paronychia, and/or other abscess involving the cutaneous and/or subcutaneous structures.

The use of incision and drainage of an abscess of the skin, subcutaneous and/or accessory structures will be considered to be medically reasonable and necessary for the treatment of a symptomatic abscess (e.g. inflamed, painful, tender) involving these structures. This includes the incision and drainage of the following types of abscess:

furuncle;

carbuncle;

suppurative hidradenitis;

an abscessed cyst;

an abscessed paronychia; and/or

other abscess of cutaneous and/or subcutaneous structures.

It would not generally be expected to see incision and drainage of an abscess of the skin, subcutaneous and/or accessory structures to be repeated frequently and/or multiple times. If frequent repeated incision and drainage is required, the medical record must reflect the reason for persistent/recurrent abscess formation, as well as any measures taken to prevent reoccurrence.

CPT/HCPCS Codes

10060 Drainage of skin abscess
10061 Drainage of skin abscess


ICD-10 Codes that Support Medical Necessity

K13.0 Diseases of lips
L02.01 Cutaneous abscess of face
L02.02 Furuncle of face
L02.03 Carbuncle of face
L02.11 Cutaneous abscess of neck
L02.12 Furuncle of neck
L02.13 Carbuncle of neck
L02.211 Cutaneous abscess of abdominal wall
L02.212 Cutaneous abscess of back [any part, except buttock]
L02.213 Cutaneous abscess of chest wall
L02.214 Cutaneous abscess of groin
L02.215 Cutaneous abscess of perineum
L02.216 Cutaneous abscess of umbilicus
L02.221 Furuncle of abdominal wall
L02.222 Furuncle of back [any part, except buttock]
L02.223 Furuncle of chest wall
L02.224 Furuncle of groin
L02.225 Furuncle of perineum
L02.226 Furuncle of umbilicus
L02.231 Carbuncle of abdominal wall
L02.232 Carbuncle of back [any part, except buttock]
L02.233 Carbuncle of chest wall
L02.234 Carbuncle of groin
L02.235 Carbuncle of perineum
L02.236 Carbuncle of umbilicus
L02.31 Cutaneous abscess of buttock
L02.32 Furuncle of buttock
L02.33 Carbuncle of buttock
L02.411 Cutaneous abscess of right axilla
L02.412 Cutaneous abscess of left axilla
L02.413 Cutaneous abscess of right upper limb
L02.414 Cutaneous abscess of left upper limb
L02.415 Cutaneous abscess of right lower limb
L02.416 Cutaneous abscess of left lower limb
L02.421 Furuncle of right axilla
L02.422 Furuncle of left axilla
L02.423 Furuncle of right upper limb
L02.424 Furuncle of left upper limb
L02.425 Furuncle of right lower limb
L02.426 Furuncle of left lower limb
L02.431 Carbuncle of right axilla
L02.432 Carbuncle of left axilla
L02.433 Carbuncle of right upper limb
L02.434 Carbuncle of left upper limb
L02.435 Carbuncle of right lower limb
L02.436 Carbuncle of left lower limb
L02.511 Cutaneous abscess of right hand
L02.512 Cutaneous abscess of left hand
L02.521 Furuncle right hand
L02.522 Furuncle left hand
L02.531 Carbuncle of right hand
L02.532 Carbuncle of left hand
L02.611 Cutaneous abscess of right foot
L02.612 Cutaneous abscess of left foot
L02.619 Cutaneous abscess of unspecified foot
L02.621 Furuncle of right foot
L02.622 Furuncle of left foot
L02.631 Carbuncle of right foot
L02.632 Carbuncle of left foot
L02.811 Cutaneous abscess of head [any part, except face]
L02.818 Cutaneous abscess of other sites
L02.821 Furuncle of head [any part, except face]
L02.828 Furuncle of other sites
L02.831 Carbuncle of head [any part, except face]
L02.838 Carbuncle of other sites
L02.91 Cutaneous abscess, unspecified
L02.92 Furuncle, unspecified
L02.93 Carbuncle, unspecified
L03.011 Cellulitis of right finger
L03.012 Cellulitis of left finger
L03.019 Cellulitis of unspecified finger
L03.031 Cellulitis of right toe
L03.032 Cellulitis of left toe
L03.039 Cellulitis of unspecified toe
L03.111 Cellulitis of right axilla
L03.112 Cellulitis of left axilla
L03.113 Cellulitis of right upper limb
L03.114 Cellulitis of left upper limb
L03.115 Cellulitis of right lower limb
L03.116 Cellulitis of left lower limb
L03.211 Cellulitis of face
L03.221 Cellulitis of neck
L03.311 Cellulitis of abdominal wall
L03.312 Cellulitis of back [any part except buttock]
L03.313 Cellulitis of chest wall
L03.314 Cellulitis of groin
L03.315 Cellulitis of perineum
L03.316 Cellulitis of umbilicus
L03.317 Cellulitis of buttock
L03.811 Cellulitis of head [any part, except face]
L03.818 Cellulitis of other sites
L03.90 Cellulitis, unspecified
L73.2 Hidradenitis suppurativa
N48.21 Abscess of corpus cavernosum and penis
N48.22 Cellulitis of corpus cavernosum and penis
N48.29 Other inflammatory disorders of penis
N61 Inflammatory disorders of breast

Comment: A commenter stated if paronychia is considered a nail margin inflammation, then removing a portion of the nail plate and relieve the pressure with packing is appropriate. However, if there is an infection, then an incision and drainage is needed. CPT code 10060 or 10061 is appropriate in this case


Response: We agree if an infection is present and incision and drainage is necessary, then it is appropriate to report CPT code 10060. If no infection is present, and the nail plate is removed to relieve pressure, then it is inappropriate to use the incision and drainage CPT codes.

Comment: A commenter stated there are times when the nail (plate total or partial) needs to be avulsed in order to perform the incision and drainage for the abscess. Therefore, CPT codes10060 or 10061 is the appropriate and CPT code 11730 is incidental. This is consistent with the National Correct Coding Initiative (NCCI) which bundles CPT code 11730 into CPT codes 10060 and10061. We believe the LCD should be consistent with NCCI.

Response: If the avulsion of the nail plate alone is sufficient to drain the abscess, this is the service which should be billed, (i.e. 11730). If, however, it is necessary to remove part of the nail plate in order to complete the drainage of the abscess, then the incision and drainage codes are appropriate. We believe this is appropriately explained in the LCD and no change is necessary.

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