2025 CPT code 10040
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Acne Surgery Integumentary System Feed
Surgical removal or drainage of acne lesions (milia, comedones, cysts, pustules).
Modifiers may be applicable depending on the circumstances of the service, such as 22 (increased procedural services), 51 (multiple procedures), 59 (distinct procedural service), and others.
Medical necessity is established when the acne lesions are symptomatic, causing pain, inflammation, or cosmetic concerns.The treatment must be deemed appropriate and necessary by the treating physician.Documentation supporting medical necessity must be present.
The physician is responsible for properly assessing the acne lesions, selecting the appropriate treatment method (extraction, excision, or marsupialization), performing the procedure, ensuring proper wound care, and providing post-operative instructions to the patient.
In simple words: This code covers the doctor's work in removing or draining acne bumps, like blackheads, whiteheads, cysts, or pus-filled pimples.Small bumps might be squeezed out, while larger ones may need a small cut to drain or be removed completely.
This CPT code encompasses the surgical treatment of acne lesions, including the extraction of contents from acne lesions using suction instruments, excision of lesions, or marsupialization of larger lesions or cysts.The procedure involves the removal of various acne formations such as milia, comedones (blackheads and whiteheads), cysts, and pustules.For smaller lesions like comedones, mechanical extraction with an instrument might suffice. Larger lesions may require incision and drainage, or in the case of very large cysts, marsupialization, which involves creating an opening, draining the contents, and suturing the edges to allow continued drainage.
Example 1: A patient presents with multiple closed comedones (whiteheads) on the face. The physician performs multiple extractions using a comedone extractor., A patient presents with a large, inflamed cystic acne lesion on the back. The physician performs an incision and drainage procedure to remove the purulent material., A patient has a large epidermoid cyst on the arm. The physician performs a marsupialization procedure, creating an opening, draining the cyst contents, and suturing the edges of the cyst lining to allow for continued drainage.
Detailed medical history, physical examination documenting the location, size, and number of lesions; photographs of lesions; description of the procedure performed (extraction, excision, or marsupialization); documentation of anesthesia used (if any); and post-operative instructions provided to the patient.Note any complications encountered.
** This code may not cover all aspects of acne treatment.Separate codes might be necessary for related services, such as anesthesia or wound care.Always refer to the most up-to-date CPT manual and payer guidelines for clarification.
- Revenue Code: P6A (Minor Procedures - Skin)
- RVU: Information not available in source data. Consult a relevant fee schedule or the CMS website for current RVU values.
- Global Days: Information not available in provided data. The global period will vary depending on payer and specific procedure performed. Clarification is needed on the specific surgical procedure performed to determine global days.
- Payment Status: Active
- Modifier TC rule: Not applicable, as this code represents the entire procedure, not a technical component.
- Fee Schedule: Information not provided in source data.Consult historical fee schedules relevant to the date of service.
- Specialties:Dermatology
- Place of Service:Office, Clinic, Ambulatory Surgical Center