Summary & Overview
CPT 10140: Incision and Drainage of Hematoma, Seroma, or Fluid Collection
CPT code 10140 is a widely utilized billing code for the surgical incision and drainage of hematomas, seromas, or other fluid collections in the skin and subcutaneous tissues. This procedure is essential in clinical practice for managing localized fluid accumulations, often performed in office or ambulatory surgical center settings. The code also covers removal of a foreign body when necessary, making it relevant for a range of minor surgical interventions.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare, recognize and reimburse for CPT code 10140. Understanding the nuances of this code is important for providers, billing professionals, and policy analysts, as it impacts reimbursement, compliance, and clinical workflow.
This publication offers a comprehensive overview of CPT code 10140, including payer coverage, clinical context, and related policy updates. Readers will gain insights into benchmarks for utilization, typical sites of service, and the role of this procedure in the broader landscape of surgical skin and subcutaneous interventions. The article also highlights relevant modifiers and associated diagnoses, providing a clear framework for understanding how CPT code 10140 fits into national billing and clinical practice.
CPT Code Overview
CPT code 10140 describes the surgical procedure of incision and drainage of a hematoma, seroma, or other fluid collection within the skin or subcutaneous tissues. This procedure may also include removal of a foreign body if present. It is classified as a surgical incision and drainage procedure on the integumentary system, typically performed in an office setting (Place of Service 11) or an ambulatory surgical center (Place of Service 24). The service is commonly used to treat localized fluid accumulations that require intervention to prevent infection or relieve discomfort.
Clinical & Coding Specifications
Clinical Context
A patient presents to the office with a localized swelling on the skin, such as a hematoma, seroma, or fluid collection, possibly following trauma or a surgical procedure. The area may be tender, red, or show signs of infection. The physician evaluates the site and determines that an incision and drainage is necessary to relieve the fluid collection and reduce symptoms. The procedure is performed in the office or ambulatory surgical center, sometimes including removal of a foreign body if present. Post-procedure, the patient may require wound care and follow-up to monitor for infection or recurrence.
Coding Specifications
Common Modifiers:
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Modifier
58: Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period. Used when the procedure is planned or staged as part of the treatment following an initial surgery. -
Modifier
78: Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period. Used when the patient returns unexpectedly for a related procedure due to complications or recurrence.
Associated Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
208600000X | Surgery Physician |
207XS0117X | Plastic Surgery Physician |
207N00000X | Dermatology Physician |
These taxonomies represent providers specializing in general surgery, plastic surgery, and dermatology, all of whom may perform incision and drainage procedures on the skin and subcutaneous tissues.
Related Diagnoses
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L02.91: Cutaneous abscess, unspecified- Indicates a localized collection of pus in the skin, often requiring incision and drainage as performed in
10140.
- Indicates a localized collection of pus in the skin, often requiring incision and drainage as performed in
-
L03.90: Cellulitis, unspecified- Represents a diffuse skin infection that may accompany or result from a fluid collection needing drainage.
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T81.4XXA: Infection following a procedure, initial encounter- Used when the fluid collection is a complication of a prior surgical procedure, necessitating drainage.
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M79.89: Other specified soft tissue disorders- Covers miscellaneous soft tissue conditions that may present as fluid collections requiring incision and drainage.
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R22.9: Localized swelling, mass and lump, unspecified- Used for undiagnosed swellings or lumps that are found to be fluid collections and treated with incision and drainage.
Related CPT Codes
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10120: Incision and drainage, finger abscess; simple- Used for simple abscesses located on the finger. Related to
10140but more specific to finger location.
- Used for simple abscesses located on the finger. Related to
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10121: Incision and drainage, finger abscess; complicated- Used for complicated finger abscesses requiring more extensive drainage. Alternative to
10140when the abscess is on the finger and is complex.
- Used for complicated finger abscesses requiring more extensive drainage. Alternative to
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10160: Incision and drainage of pilonidal cyst or sinus- Used for pilonidal cysts or sinuses, typically located near the sacrococcygeal area. Related to
10140as both involve incision and drainage, but10160is specific to pilonidal disease.
- Used for pilonidal cysts or sinuses, typically located near the sacrococcygeal area. Related to
These codes are alternatives or complements to 10140 depending on the anatomical site and complexity of the fluid collection. They are not typically used together but may be selected based on the clinical scenario.
National Reimbursement Benchmarks
For CPT code 10140, the national mean rate for Medicare is $180.34, while the average commercial benchmark (BUCA) is $185.15. Commercial payers such as UnitedHealth Group and Cigna report notably higher mean rates, at $253.75 and $240.28 respectively, compared to both Medicare and BUCA.
Rate dispersion varies significantly across payers. Medicare exhibits the tightest range, with a difference of only $18.00 between the 75th and 25th percentiles, indicating consistent reimbursement. In contrast, UnitedHealth Group shows the widest spread, with a $153.00 difference between the 75th and 25th percentiles, reflecting greater variability in rates. Blue Cross Blue Shield and Cigna also display substantial dispersion, while Aetna and BUCA are more moderate.
The table and chart below present a detailed breakdown of national benchmarks for each payer.
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