curettement (frequently referred to as curettage) is the surgical scraping or cleaning of a biological surface, cavity, or lesion using a spoon-shaped instrument called a curette. It is performed to remove abnormal, infected, or dead tissue for therapeutic purposes, or to obtain a tissue sample for diagnosticbiopsy. Unlike excision, which involves cutting out tissue full-thickness with a scalpel, curettement relies on a scraping motion that often preserves the underlying healthy tissue matrix and does not typically require layered closure. It can be a primary therapeutic modality (e.g., removal of a chalazion in ophthalmology or a benign skin lesion) or an adjunctive step (e.g., following electrodesiccation in dermatology or during mastoid cavity cleaning in otolaryngology). The most common clinical applications encountered in coding include dermatologic lesion destruction, ophthalmologicchalazion incision and curettage (I&C), and otolaryngologic removal of granulation tissue. It is commonly confused with debridement, which is the broader removal of necrotic tissue and foreign material from a wound, whereas curettement specifically implies the use of a curette for scraping a defined surface, tract, or lesion.
Noun-forming suffix — “action or process of,” “result of”
The word entered English in the 1880s as curettement (noun), borrowed from French curettement, from curette (a scraper), from Latin curare — literally “the process of cleansing or scraping with a scoop.” The root curare (“to care for or cleanse”) connects curettement to the entire cur- family: cure (to heal or restore to health), curator (one who cares for or manages), and incurable (unable to be healed). The alternative suffix -age is more commonly used today, making curettage the dominant clinical synonym.
🔀 ALIASES / ALTERNATE TERMS
Curettage(primary clinical synonym; used interchangeably in operative reports, e.g., “incision and curettage”)
Scraping(lay term; often used in ophthalmology, e.g., “corneal scraping”)
Incision and Curettage (I&C)(combined modality; standard treatment for chalazia and certain cysts)
Electrodesiccation and Curettage (ED&C)(dermatologic combined modality; used for destruction of basal cell carcinomas or benign lesions)
Corneal curettement(ophthalmologic subtype; scraping of the cornea for diagnostic smear/culture or to remove epithelium)
Mastoid curettage(otolaryngologic subtype; scraping of granulation tissue or cholesteatoma remnants from the mastoid cavity)
Endocervical curettage (ECC)(gynecologic subtype; scraping of the cervical canal, often performed with colposcopy)
Bone curettage(orthopedic/ENT subtype; scraping of bone cysts or osteomyelitis tracts)
🔗 RELATED TERMS
Excision — surgical removal by cutting with a scalpel; distinct from curettement because excision involves full-thickness removal of the lesion and margins, whereas curettement scrapes the surface.
Debridement — the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue; broader than curettement.
Biopsy — removal of tissue for diagnostic examination; tangential or shave biopsies are frequently performed using a curette.
Electrodesiccation — the drying of tissue by a high-frequency electric current applied with a needle-shaped electrode; frequently paired with curettement (ED&C) for lesion destruction.
Chalazion — a localized swelling (lipogranuloma) of the eyelid resulting from obstruction of a meibomian gland; the classic ophthalmologic indication for incision and curettement.
Cholesteatoma — a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear/mastoid; often requires curettement during tympanomastoidectomy.
Actinic Keratosis — a precancerous patch of thick, scaly, or crusty skin; commonly treated via destruction using a curette.
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular lesions; up to 14 lesions
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy (urology context)
⚠️ Coding Note: When coding procedures involving a curette, the coder must carefully distinguish between biopsy, destruction, and excision based on the provider’s intent and technique. In CPT, if a curette is used to obtain a tissue sample and the remaining lesion is left intact or treated with another method, it is coded as a tangential biopsy (11102). If the curette is used to completely destroy or remove a benign or premalignant lesion, it is coded as destruction (e.g., 17000, 17110) rather than excision, because true excision (11400 series) requires full-thickness removal with a scalpel. For ophthalmology, chalazionexcision (67800-67808) inherently includes incision and curettement (I&C); do not unbundle the incision. Under Noridian MAC (JE/JF) LCDs, destruction of benign lesions (17110) requires strict medical necessity documentation (e.g., bleeding, pain, obstruction of vision, or rapid growth) to be billable; cosmetic curettement is non-covered. Always append appropriate eyelid modifiers (-E1--E4) or laterality modifiers (-RT/-LT) to ophthalmologic and otolaryngologic curettement codes.