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Q&A Puncture Aspiration CPT code

K

Karthick

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Can we use 10160 for puncture aspiration of Hematoma in Head?

Will insurance reimburse for the code 10160 with dx 920?
 

Ruth Sheets

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You can get the top pairings of ICD-9-CM or CPT® codes submitted on Medicare and private payer claims by using Supercoder's CPT-ICD-9-CM Crosswalk. I looked up 10160, and 920 was one of the many diagnosis codes paired with it.


920 Contusion of face scalp and neck except eye(s)
10160 Puncture aspiration of abscess, hematoma, bulla, or cyst

Supercoder has a free trial of 14 days if you want to try it.

Here is the definition of contusion from http://medical-dictionary.thefreedictionary.com/

contusion [kon-too´zhun]
injury to tissues with skin discoloration and without breakage of skin; called also bruise. Blood from the broken vessels accumulates in surrounding tissues, producing pain, swelling, and tenderness, and the discoloration is the result of blood seepage just under the skin. Most heal without special treatment, but cold compresses may reduce bleeding if applied immediately after the injury, and thus may reduce swelling, discoloration, and pain.

If a contusion is unusually severe, the injured part should be rested and slightly elevated; later application of heat may hasten absorption of blood. Serious complications may develop in some cases. Normally blood is drawn off from the bruised area in a few days, but occasionally blood clotted in the area may form a cyst or may calcify and require surgical treatment. Contusions may also be complicated by infection.
I'm no expert on onsurance claims, but I would think the insurance company would be obliged to do the reimbursement.
 

Ruth Sheets

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One other thought...

10160 is in the integumentary system section of CPT, so you'd use it only if the puncture aspiration was of a abscess, hematoma, etc in the skin.
 

MichaelrCPC

Michael A. Reynolds, CPC, CCP-P, CPMB, CBCS, OS
You have to remember that I&D codes are devided according to the condition for which the I&D is being performed. Acne surg., abcess, carbuncle, boil, cyst, hematoma and wound infect. Included in those is the puncture aspiration (10160), which is basically inserting a needle into a lesion and withdrawing the fluid. If the hmatoma is superficial, whicx they most likely are go ahead with the 10160. Your 920(catagory code) is fne as long as it does not pertain to any other part of the head. When you look up contusion, head in your alpha it directs you to 920. even though your 920 does not mention head you cn trust that the alpha gave you ther right direction
 
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