Incision and Drainage FAQ

What should I document for an incision and discharge (I&D)?

Documentation for an incision and drainage or puncture aspiration should include precise location, the type of lesion (e.g., abscess, paronychia, hidradenitis suppurativa, furuncle, carbuncle, lymphangitis, hematoma, cyst), a description of the procedure to include whether incision or puncture, amount and quality of drainage, probing and deloculation when performed, and whether wound was packed, drain inserted or left open.

Use care choosing the correct CPT® codes. Some descriptors indicate incision or puncture, while others do not specify the type of approach for a specific location. Similarly, ICD-10-CM diagnosis codes linked to the procedure should accurately reflect the location and type of lesion drained.

What is the difference between a simple and complicated I&D?

Complexity of an I&D is determined by the provider. Generally, a complicated I&D may include wound packing, drain insertion, and/or probing and deloculation. Multiple skin or subcutaneous I&D during the same encounter are coded as complicated, rather than coding multiple simple I&D, per CPT®.

Is ultrasound separately billable when an I&D is performed?

Ultrasound interpretation is a separately billable service frequently used to diagnose and locate a cyst, hematoma, seroma or abscess. Permanent image retention and documented findings related to the reason the study was performed are necessary to capture ultrasound as a separately billable service.  There are ultrasound codes available specifically for soft tissue of the head and neck (CPT 76536) and soft tissue of non-vascular extremity structure (CPT 76882). Additional ultrasound codes are assigned by body area, including abdomen (CPT 76705) or chest/upper back (CPT 76604), and scrotum contents (CPT 76870). Use the -26 modifier to indicate professional component interpretation. If an ultrasound code description does not indicate limited study, a -52 reduced service modifier may be appropriate.   

For additional information, see the ACEP FAQ for Ultrasounds.

What are some examples of I&D codes available?

The following list provides some examples of incision and drainage as well as puncture aspiration codes frequently performed in the emergency department: 


Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single


Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple


Incision and drainage of pilonidal cyst; simple


Incision and drainage of pilonidal cyst; complicated


Incision and drainage of hematoma, seroma or fluid collection


Puncture aspiration of abscess, hematoma, bulla, or cyst


Evacuation of subungual hematoma


Puncture aspiration of cyst of breast


Drainage of abscess, cyst, hematoma, vestibule of mouth; simple


Drainage of abscess, cyst, hematoma from dentoalveolar structures


Incision and drainage, perianal abscess, superficial


Incision of thrombosed hemorrhoid, external


Drainage of scrotal wall abscess


Incision and drainage of vulva or perineal abscess


Incision and drainage of Bartholin's gland abscess


Drainage external ear, abscess or hematoma; simple


Drainage external ear, abscess or hematoma; complicated

How do I bill for follow-up visits after an I&D?

Most incision and drainage or puncture aspiration codes utilized in the emergency department carry a ten (10) day global period. Routine follow-up visits to the same ED, seen by the same provider/group, and limited to re-evaluation of the uncomplicated post-procedural wound may be captured with CPT® 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure). 

If the patient presents during the 10-day global period with additional medical problems or conditions unrelated to the incision and drainage or puncture aspiration (e.g., diabetes or URI), an Evaluation/Management Level may be billed with a -24 modifier to indicate an unrelated E/M service by the same physician or other qualified health care professional during a postoperative period.  

Updated April 2023


The American College of Emergency Physicians (ACEP) has developed the Reimbursement & Coding FAQs and Pearls for informational purposes only.   The FAQs and Pearls have been developed by sources knowledgeable in their fields, reviewed by a committee, and are intended to describe current coding practice. However, ACEP cannot guarantee that the information contained in the FAQs and Pearls is in every respect accurate, complete, or up to date.

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For information about this FAQ/Pearl, or to provide feedback, please contact David A. McKenzie, ACEP Reimbursement Director at (469) 499-0133 or

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