Overview of CPT Code 10035: Incision and drainage of pilonidal cyst
CPT Code 10035 refers to the surgical procedure for incision and drainage of a pilonidal cyst, which is a common condition characterized by a cyst or abscess located near the tailbone.
When CPT Code 10035 is Used?
This procedure is indicated in specific clinical scenarios.
- Presence of a painful pilonidal cyst or abscess.
- Recurrent infections in the pilonidal area.
- Failure of conservative treatments such as antibiotics or drainage.
Symptoms Indicating This Procedure
Patients typically report various symptoms that may necessitate this procedure.
- Severe pain in the lower back or tailbone area.
- Swelling and redness around the cyst.
- Drainage of pus or blood from the cyst.
- Foul odor from the infected area.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention.
- Hair growth in the sacrococcygeal area.
- Prolonged sitting or pressure on the tailbone.
- Poor hygiene or excessive sweating.
- Family history of pilonidal disease.
Diagnostic Tests Before Procedure
Certain tests may be conducted to confirm the diagnosis.
- Physical examination of the cyst.
- Ultrasound to assess the extent of the cyst.
- Culture of any drainage to identify infection.
Procedure Description
The procedure involves several key steps.
- Patient is positioned comfortably, usually lying on their stomach.
- Area around the cyst is cleaned and sterilized.
- Local anesthesia is administered to numb the area.
- An incision is made over the cyst to allow drainage.
- The cyst cavity is cleaned and any debris is removed.
- The incision may be left open to allow for further drainage.
Preparation for the Procedure
Patients should follow specific guidelines before the procedure.
- Avoid eating or drinking for several hours prior to the procedure.
- Inform the doctor of any medications being taken.
- Arrange for transportation home after the procedure.
Recovery and Aftercare
Post-procedure care is crucial for recovery.
- Rest for the first few days after the procedure.
- Keep the area clean and dry.
- Change dressings as instructed by the healthcare provider.
- Take prescribed pain medications as needed.
Possible Complications
While generally safe, there are potential risks involved.
- Infection at the incision site.
- Bleeding or hematoma formation.
- Recurrence of the pilonidal cyst.
- Scarring in the affected area.
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Post-Procedure Follow-Up
Follow-up appointments are important for monitoring recovery.
- Schedule a follow-up visit within 1-2 weeks post-procedure.
- Monitor for signs of infection or complications.
- Discuss any concerns with the healthcare provider.
Alternative Treatments
There are non-surgical options available for managing pilonidal cysts.
- Antibiotics for infection management.
- Warm compresses to reduce discomfort.
- Sitz baths to promote hygiene and healing.
Home Care Tips
Patients can take steps at home to aid recovery.
- Avoid sitting for long periods to reduce pressure.
- Maintain good hygiene in the affected area.
- Wear loose-fitting clothing to prevent irritation.
Patient Education & Prevention
Educating patients can help prevent recurrence.
- Practice good hygiene, especially in the lower back area.
- Consider regular hair removal in the affected area.
- Avoid prolonged sitting and maintain a healthy weight.
Billing and Coding Information
CPT Code: 10035
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- LT - Left side
- RT - Right side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $1,500 to $3,000.
- Most insurance plans cover the procedure if deemed medically necessary.
Related CPT Codes
- 10030 - Incision and Drainage of Skin Abscess
- 10140 - Incision and drainage of hematoma
- 11000 - Debridement of skin, subcutaneous tissue
- 12001 - Simple Repair of Laceration, Face, Ears, Eyelids, Nose
References and Sources
Frequently Asked Questions (FAQs)
What is a pilonidal cyst?
A pilonidal cyst is a sac filled with fluid or pus that forms near the tailbone.
How long does recovery take?
Recovery typically takes a few weeks, depending on the severity of the cyst.
Will I need to take time off work?
You may need to take a few days off, especially if your job involves sitting for long periods.
Can pilonidal cysts come back?
Yes, pilonidal cysts can recur, especially if preventive measures are not taken.
