This is reported with a single code, 11044. When subcutaneous tissue is debrided from a 16 s. cm dehisced abdominal wound and a 10 sq cm thigh wound, report 11042 for the first 20 sq cm and 11045 for the second 6 sq cm.
Full Answer
The diabetes with manifestation code is always first listed according to the coding guidelines. The diabetes is coded first. The ICD-9 index under "ulcer, diabetes, foot" indicates to use 250.8x and "ulcer, foot" to use 707.15.
Two ulcers: first 2cm x 2cm, second 4cm x 4cm both debrided to dermis 97597 one unit Three ulcers: 2cm x 2cm, 3cm x 2cm, 2cm x 2cm all three debrided to dermis 97597 one unit 97598 Add-on code to 97597 To be used if wound over 20 sq. cm Debridement of open wound to level of epidermis / dermis each additional 20 square centimeters
Documentation stating “excisional debridement” is not enough to code excisional debridement. The AHA Coding Clinic for ICD-9-CM has provided much guidance on when to code ICD-9 Code 86.22, Excisional debridement of wound, infection or burn.
subcutaneous tissue (includes epidermis and dermis, if performed) – 11042 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less and 11045 … each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
CPT 11045 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq. cm, or part thereof.
According to the AMA CPT Manual, debridement of an ulcer that is limited to the skin (epidermis and/or dermis) should correctly be reported with active wound care management codes 97597 and 97698 depending on size, and not the surgical debridement CPT codes 11042-11047.
If an excisional debridement the code would be 0HBMXZZ Excision of right foot skin, external approach. Example: Excisional debridement of skin, subcutaneous tissue, and muscle of buttocks. (Accounting for laterality), 0KBP3ZZ Excision of left hip muscle, percutaneous approach.
During sharp debridement, one uses a scalpel, curette, tissue nipper or other tool to remove all non-vital tissue. This also removes potential contaminants, bacterial burden or biofilm from the bed and edges of a wound. Sharp debridement is quick, highly selective and is applicable to almost all wound types.
“Debridement of the skin and subcutaneous tissue is a procedure by which foreign material and devitalized or contaminated tissue are removed from a traumatic or infected lesion until the surrounding health tissue is exposed.
622).” Of these options, the most commonly used codes for diabetic foot ulcers are E10. 621 (Type 1 diabetes mellitus with foot ulcer) and E11. 621 (Type 2 diabetes mellitus with foot ulcer).
For excisional debridement of muscle or fascia, coders would report CPT code 11043 (debridement, muscle or fascia [includes epidermis, dermis, and subcutaneous tissue, if performed]; first 20 sq. cm or less) for the first 20 sq. cm and add-on code 11046 (debridement, muscle or fascia; each additional 20 sq.
Debridement definition Debridement is the removal of dead (necrotic) or infected skin tissue to help a wound heal. It's also done to remove foreign material from tissue. The procedure is essential for wounds that aren't getting better. Usually, these wounds are trapped in the first stage of healing.
One thing to keep in mind, is the difference between an excisional debridement and a non-excisional debridement. An excisional debridement: Is a surgical procedure that involves an excisional method of removal, or cutting away tissue, necrosis and/or slough. Groups to a surgical MS-DRG.
CPT 97597 is for the debridement of an ulcer to the level of epidermis/dermis if the total sq cm of tissue removed is less than or equal to 20 sq cm.
Debridement is an important component of standard wound treatment for diabetic foot ulcers (Frykberg, 2015). It involves removal of necrotic tissue, foreign debris, bacterial growth, callus, wound edge, and wound bed tissue from chronic wounds in order to stimulate the wound healing process.
Wound debridement codes (not associated with fractures) are reported with CPT codes 11042-11047. Wound debridements are reported by the depth of tissue that is removed and the surface area of the wound. These services may be reported for injuries, infections, wounds, and chronic ulcers.
An excisional debridement of the skin or subcutaneous tissue is the surgical removal or cutting away of such tissue, necrosis, or slough and is classified to the root operation Excision. Excisional debridement involves the use of a scalpel to remove devitalized tissue.
Debridement can be categorized as excisional or non- excisional.”. The same Coding Clinic further directs the coder to code excisional debridement when either “the provider documents ‘excisional debridement’ in the body of the operative report, and/or the documentation meets the root operation definition of ‘Excision.’”.