Date Issued: 5/3/2019
EmblemHealth has been implementing payment policies that reflect guidelines set forth by industry authorities. Our goal is to process claims consistently and in accordance with best practice standards.
EmblemHealth has instituted additional payment policies for Pilonidal Cyst and Sinus Procedures.
According to the AMA CPT Manual, Integumentary section, codes 10080-10081 (Incision and drainage of pilonidal cyst) or 11770-11772 (Excision of pilonidal cyst or sinus) must include an ICD-10 diagnosis code of Pilonidal Cyst or Pilonidal Sinus.
