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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.
Debridement is generally associated with injuries, infections, wounds, and/or ulcers. It is also a procedure that may be part of fracture care as well, and it is separately payable. To better understand how to code for wound debridement properly, let’s first look at why debridement is performed, and how it’s accomplished.
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)
Using a VersaJet debrider, the physician performed debridement of the skin and subcutaneous tissue. How should this procedure be coded? Assign code 0HDHXZZ, Extraction of right upper leg skin, external approach, for the nonexcisional debridement using VersaJet.
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.
For debridement codes 97597, 97598, or 97602: Debridements should be coded with either selective or non-selective CPT codes (97597, 97598, or 97602) unless the medical record supports a surgical debridement has been performed.
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.
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.
1. Active wound care, performed with minimal anesthesia is billed with either CPT code 97597 or 97598. 2. Debridement of a wound, performed before the application of a topical or local anesthesia is billed with CPT codes 11042 – 11047.
Surgical removal or cutting away of devitalized tissue, necrosis, or slough. down to viable tissue using a blade/scalpel (not scissors), and outside or beyond wound margin.
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 of a wound, performed before the application of a topical or local anesthesia is billed with CPT codes 11042 - 11047. Wound debridements (11042-11047) are reported by depth of tissue that is removed and by surface area of the wound.
These include surgical debridement, biological debridement, enzymatic debridements, and autolytic debridement.
Debridement is the word used to describe a specific surgical procedure. In a debridement, the surgeon removes damaged tissue from the body to promote healing. Tissue removed may be: Dead.
The use of a VersaJet, without additional surgical cutting away of tissue is classified as non-excisional.
Decontamination or debridement: CPT® specifies, “Debridement is considered a separate procedure only when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure.” [ ...
When performing debridement of a single wound, report depth using the deepest level of tissue removed. In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths. For example: Bone is debrided from a 4 sq cm heel ulcer and from a 10 sq cm ischial ulcer.
Rather, it is removal of devitalized tissue, necrosis, and slough by other methods, including: Examples of non-excisional debridement are pulsed lavage, mechanical lavage, mechanical irrigation, high-pressure irrigation, etc.
For instance, Versajet™ debridement is considered to be nonsurgical, mechanical debridement because it does not involve cutting away or excising devitalized tissue. Likewise, the Arobella Qoustic Wound Therapy System™ uses an ultrasonic assisted curette to debride wounds mechanically. Author. Recent Posts.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
This article clarifies wound care and debridement services provided by a therapist, physician, non-physician practitioner (NPP) or as incident-to services.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
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.’”.
Excisional debridement involves the use of a scalpel to remove devitalized tissue. Documentation of excisional debridement should be specific regarding the type of debridement. If the documentation is not clear or if there is any question about the procedure, the provider should be queried for clarification.
Answer: Yes, assign code 0HB8XZZ, Excision of buttock skin, external approach, for the excisional debridement of skin of the buttocks. Question: The physician performed excisional debridement of a coccyx wound down to the fascia and including bone.
Pulsed lavage is used for the debridement of bone and tissue for wound cleansing in order to remove infectious agents and debris. This method of wound cleansing is also known as “mechanical lavage,” “pulsatile lavage,” “mechanical irrigation,” and “high-pressure irrigation.”.
Answer: Coders cannot assume that the debridement of bone, fascia, or muscle is always excisional. For example, if a patient suffers a traumatic open wound and fascia, muscle, or bone is exposed, an excisional debridement may not be performed.
Answer: Yes, the documentation standard for coding excisional debridement in ICD-10-PCS is the same as it is for ICD-9-CM. As with ICD-9-CM, the words “sharp debridement” are not enough to code the root operation Excision.
Use of a sharp instrument does not always indicate that an excisional debridement was performed. Minor removal of loose fragments with scissors or using a sharp instrument to scrape away tissue is not an excisional debridement. Excisional debridement involves the use of a scalpel to remove devitalized tissue.
In many cases, only nonexcisional debridement is required to clean the wound. Therefore, providers should specifically document the type of debridement. Clear and concise documentation is needed in order to accurately report excisional debridement.