Medical Coding

Category - 10,000 Series

A 35-year-old male returns to the general surgeon’s office with recurrent episodes of infected pilonidal cysts. He has had the cyst incised and drained (I&D) once at his primary care physician’s office and once at the surgeon’s office. The last I&D was approximately four months ago. He returns to the office today to discuss further treatment. It is decided that he will undergo outpatient surgery so he can be sedated and the cyst will be excised with the base curetted. During surgery, it was noted that there was an extensive sinus tract. The wound will be packed open, requiring daily dressing changes and he will return to the postop clinic for a recheck in one week. Which of the following codes should you use?
  1. 11771
  2. 11772
  3. 11770
  4. 10080
Explanation
Answer: A - 11771 is correct for an extensive procedure because it involved excising the cyst and curetting it.

Code 11772 is not correct because, while extensive, the excision was not complicated. A complicated excision may include removal down to the sacral fascia or using the surgical technique called marsupialization. Code 11770 is incorrect because this pilonidal cyst was more complicated and was not just a simple pilonidal cyst. Code 10080 is incorrect because this was a complicated pilonidal cyst and it required more than just an I&D because it was also excised
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