Cracking the Code

Overlapping Body Layers

When reviewing medical records pertaining to incision and drainage/excision procedures, it is very important for a coder to locate documentation supporting the depth of the procedure. For ICD-10-PCS procedure codes, there are different codes provided for incision and drainage of skin and incision and drainage of subcutaneous tissue and fascia. To ensure that a coder is selecting the most appropriate code, it is imperative to have a firm understanding of skin vs subcutaneous tissue.

The skin is the outer layer of the body. The subcutaneous tissue is the deepest layer underneath the skin. When coding incision and drainage/excision procedures, it is important to code to the deepest layer. If a provider’s documentation states that an incision and drainage/excision was performed on skin and subcutaneous tissue, then it is appropriate to report the PCS code for the subcutaneous layer.

Reference: References: ICD-10-PCS Official Guidelines for Coding and Reporting Section B3.5: Overlapping body layers
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