How To Avoid I&D Denials


By: Jacqueline Thelian, CPC, CPC-I, CHCA
Medco Consultants, Inc

Are Incision & Drainage (I&D) denials draining your wallet? Ever wonder why the insurance carrier is asking for a refund on your I&D? After all you did document “I&D done”.

Well that is the problem. Simply writing what was done without a description of the procedure, the indication for the procedure and written consent will result in a claim denial.

The CPT codes for I&D (10060-10061) are located in the surgery section of the CPT manual and as such they are designated as surgical procedures. 

Let’s look at the required documentation for I&D codes 10060 & 10061. 

  • The signs and symptoms that required the I&D
  • The pre-operative size, location and appearance of any abscess, hematoma or any lesion undergoing the I&D
  • A description of the procedure to include, the equipment utilized the approximate quantity (e.g. 1cc, 5ml) and quality (e.g. serous, bloody, frank pus, etc.) of the drained material
  • How the patient tolerated the procedure and any post-op instructions
  • And don’t forget the signed consent, after all it is a surgical procedure.

So next time you document that I&D don’t let it drain your wallet with another denial. Use the checklist above to get it right and hold on to your reimbursement.