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
10060Drainage of skin abscess
10061Drainage of skin abscess
ICD-10 Codes that Support Medical Necessity
K13.0Diseases of lips
L02.01Cutaneous abscess of face
L02.02Furuncle of face
L02.03Carbuncle of face
L02.11Cutaneous abscess of neck
L02.12Furuncle of neck
L02.13Carbuncle of neck
L02.211Cutaneous abscess of abdominal wall
L02.212Cutaneous abscess of back [any part, except buttock]
L02.213Cutaneous abscess of chest wall
L02.214Cutaneous abscess of groin
L02.215Cutaneous abscess of perineum
L02.216Cutaneous abscess of umbilicus
L02.221Furuncle of abdominal wall
L02.222Furuncle of back [any part, except buttock]
L02.223Furuncle of chest wall
L02.224Furuncle of groin
L02.225Furuncle of perineum
L02.226Furuncle of umbilicus
L02.231Carbuncle of abdominal wall
L02.232Carbuncle of back [any part, except buttock]
L02.233Carbuncle of chest wall
L02.234Carbuncle of groin
L02.235Carbuncle of perineum
L02.236Carbuncle of umbilicus
L02.31Cutaneous abscess of buttock
L02.32Furuncle of buttock
L02.33Carbuncle of buttock
L02.411Cutaneous abscess of right axilla
L02.412Cutaneous abscess of left axilla
L02.413Cutaneous abscess of right upper limb
L02.414Cutaneous abscess of left upper limb
L02.415Cutaneous abscess of right lower limb
L02.416Cutaneous abscess of left lower limb
L02.421Furuncle of right axilla
L02.422Furuncle of left axilla
L02.423Furuncle of right upper limb
L02.424Furuncle of left upper limb
L02.425Furuncle of right lower limb
L02.426Furuncle of left lower limb
L02.431Carbuncle of right axilla
L02.432Carbuncle of left axilla
L02.433Carbuncle of right upper limb
L02.434Carbuncle of left upper limb
L02.435Carbuncle of right lower limb
L02.436Carbuncle of left lower limb
L02.511Cutaneous abscess of right hand
L02.512Cutaneous abscess of left hand
L02.521Furuncle right hand
L02.522Furuncle left hand
L02.531Carbuncle of right hand
L02.532Carbuncle of left hand
L02.611Cutaneous abscess of right foot
L02.612Cutaneous abscess of left foot
L02.619Cutaneous abscess of unspecified foot
L02.621Furuncle of right foot
L02.622Furuncle of left foot
L02.631Carbuncle of right foot
L02.632Carbuncle of left foot
L02.811Cutaneous abscess of head [any part, except face]
L02.818Cutaneous abscess of other sites
L02.821Furuncle of head [any part, except face]
L02.828Furuncle of other sites
L02.831Carbuncle of head [any part, except face]
L02.838Carbuncle of other sites
L02.91Cutaneous abscess, unspecified
L02.92Furuncle, unspecified
L02.93Carbuncle, unspecified
L03.011Cellulitis of right finger
L03.012Cellulitis of left finger
L03.019Cellulitis of unspecified finger
L03.031Cellulitis of right toe
L03.032Cellulitis of left toe
L03.039Cellulitis of unspecified toe
L03.111Cellulitis of right axilla
L03.112Cellulitis of left axilla
L03.113Cellulitis of right upper limb
L03.114Cellulitis of left upper limb
L03.115Cellulitis of right lower limb
L03.116Cellulitis of left lower limb
L03.211Cellulitis of face
L03.221Cellulitis of neck
L03.311Cellulitis of abdominal wall
L03.312Cellulitis of back [any part except buttock]
L03.313Cellulitis of chest wall
L03.314Cellulitis of groin
L03.315Cellulitis of perineum
L03.316Cellulitis of umbilicus
L03.317Cellulitis of buttock
L03.811Cellulitis of head [any part, except face]
L03.818Cellulitis of other sites
L03.90Cellulitis, unspecified
L73.2Hidradenitis suppurativa
N48.21Abscess of corpus cavernosum and penis
N48.22Cellulitis of corpus cavernosum and penis
N48.29Other inflammatory disorders of penis
N61Inflammatory disorders of breast
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
10060Drainage of skin abscess
10061Drainage of skin abscess
ICD-10 Codes that Support Medical Necessity
K13.0Diseases of lips
L02.01Cutaneous abscess of face
L02.02Furuncle of face
L02.03Carbuncle of face
L02.11Cutaneous abscess of neck
L02.12Furuncle of neck
L02.13Carbuncle of neck
L02.211Cutaneous abscess of abdominal wall
L02.212Cutaneous abscess of back [any part, except buttock]
L02.213Cutaneous abscess of chest wall
L02.214Cutaneous abscess of groin
L02.215Cutaneous abscess of perineum
L02.216Cutaneous abscess of umbilicus
L02.221Furuncle of abdominal wall
L02.222Furuncle of back [any part, except buttock]
L02.223Furuncle of chest wall
L02.224Furuncle of groin
L02.225Furuncle of perineum
L02.226Furuncle of umbilicus
L02.231Carbuncle of abdominal wall
L02.232Carbuncle of back [any part, except buttock]
L02.233Carbuncle of chest wall
L02.234Carbuncle of groin
L02.235Carbuncle of perineum
L02.236Carbuncle of umbilicus
L02.31Cutaneous abscess of buttock
L02.32Furuncle of buttock
L02.33Carbuncle of buttock
L02.411Cutaneous abscess of right axilla
L02.412Cutaneous abscess of left axilla
L02.413Cutaneous abscess of right upper limb
L02.414Cutaneous abscess of left upper limb
L02.415Cutaneous abscess of right lower limb
L02.416Cutaneous abscess of left lower limb
L02.421Furuncle of right axilla
L02.422Furuncle of left axilla
L02.423Furuncle of right upper limb
L02.424Furuncle of left upper limb
L02.425Furuncle of right lower limb
L02.426Furuncle of left lower limb
L02.431Carbuncle of right axilla
L02.432Carbuncle of left axilla
L02.433Carbuncle of right upper limb
L02.434Carbuncle of left upper limb
L02.435Carbuncle of right lower limb
L02.436Carbuncle of left lower limb
L02.511Cutaneous abscess of right hand
L02.512Cutaneous abscess of left hand
L02.521Furuncle right hand
L02.522Furuncle left hand
L02.531Carbuncle of right hand
L02.532Carbuncle of left hand
L02.611Cutaneous abscess of right foot
L02.612Cutaneous abscess of left foot
L02.619Cutaneous abscess of unspecified foot
L02.621Furuncle of right foot
L02.622Furuncle of left foot
L02.631Carbuncle of right foot
L02.632Carbuncle of left foot
L02.811Cutaneous abscess of head [any part, except face]
L02.818Cutaneous abscess of other sites
L02.821Furuncle of head [any part, except face]
L02.828Furuncle of other sites
L02.831Carbuncle of head [any part, except face]
L02.838Carbuncle of other sites
L02.91Cutaneous abscess, unspecified
L02.92Furuncle, unspecified
L02.93Carbuncle, unspecified
L03.011Cellulitis of right finger
L03.012Cellulitis of left finger
L03.019Cellulitis of unspecified finger
L03.031Cellulitis of right toe
L03.032Cellulitis of left toe
L03.039Cellulitis of unspecified toe
L03.111Cellulitis of right axilla
L03.112Cellulitis of left axilla
L03.113Cellulitis of right upper limb
L03.114Cellulitis of left upper limb
L03.115Cellulitis of right lower limb
L03.116Cellulitis of left lower limb
L03.211Cellulitis of face
L03.221Cellulitis of neck
L03.311Cellulitis of abdominal wall
L03.312Cellulitis of back [any part except buttock]
L03.313Cellulitis of chest wall
L03.314Cellulitis of groin
L03.315Cellulitis of perineum
L03.316Cellulitis of umbilicus
L03.317Cellulitis of buttock
L03.811Cellulitis of head [any part, except face]
L03.818Cellulitis of other sites
L03.90Cellulitis, unspecified
L73.2Hidradenitis suppurativa
N48.21Abscess of corpus cavernosum and penis
N48.22Cellulitis of corpus cavernosum and penis
N48.29Other inflammatory disorders of penis
N61Inflammatory disorders of breast