The following claims edit will go into effect July 30, 2019:
Policy: Pilonidal cyst and pilonidal sinus procedures
Policy description: Incision and drainage of a pilonidal cyst (10080-10081) and excision of a pilonidal cyst or sinus (11770-11772) should only be reported with a diagnosis of pilonidal cyst or pilonidal sinus (ICD-10 codes L05-L05.92). These procedures will be denied when reported without an appropriate diagnosis.
Reference: AMA CPT Manual
Plans affected: ConnectiCare commercial and Medicare Advantage plans