2025 CPT code 10140
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Integumentary System Feed
Incision and drainage of hematoma, seroma, or fluid collection.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (modifier 22), multiple procedures (modifier 51), or reduced services (modifier 52).Other modifiers may be appropriate depending on the specific payer and circumstances.
Medical necessity is established by the presence of a symptomatic fluid collection causing pain, discomfort, or impaired function. Documentation should support the need for drainage.
In simple words: This procedure drains fluid buildup under the skin, like a blood clot (hematoma) or clear fluid (seroma). The doctor makes a small cut to let the fluid out and may close the cut with stitches or leave it open to heal.
The procedure involves making an incision into a hematoma, seroma, or other fluid collection beneath the skin.The physician uses blunt dissection to penetrate the collection and allow the fluid to drain.The incision may be closed primarily, left to heal by secondary intention, or packed. A pressure dressing may be applied.
Example 1: A patient presents with a painful, fluctuant hematoma on the thigh following a fall.The hematoma is incised and drained using code 10140., A patient develops a seroma at a surgical site following a breast lumpectomy.The seroma is aspirated using a needle and syringe.This would also be coded as 10140 as the code describes drainage by any method including aspiration., A patient with a history of lymphedema develops a large, subcutaneous fluid collection in the arm. The fluid collection is incised and drained, and a drain is placed to facilitate continued drainage. This complex drainage is also covered by 10140 as it pertains to any fluid collection.
Documentation should include the location, size, and nature of the fluid collection, the method of drainage, whether the incision was closed or packed, and any complications encountered.
- Specialties:General surgery, plastic surgery, dermatology, and other surgical specialties may utilize this code.
- Place of Service:This procedure can be performed in a variety of settings, including physician offices, outpatient surgical centers, and hospitals (inpatient or outpatient).