,P* &r4DH#.|QW" ss You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. Secondary Payor Doesnt Recognize Consultations. 3]HE1}}&Z\d3aD)6C~NYZgois\t-w;s3N>dgp@GtBisMaq)%le"Z\g.j4 9qEb*NLaQD\/z a\)DC|[JkHHq\J.d&X. Remember that the debridement codes, 11042-11047, are reported when you debride an open wound that will stay open to heal by secondary intention. Replacement material, graft size, multiple wounds all these factors and more will come into play when youre coding a skin replacement surgery using skin substitute grafts for conditions such as burns. hb```b``Qg`e`y @16.5&Gsf cQ"b8)l82+q {5lJ,lhn7: YZGA 3*l910eX,_ ,*KodXD78^mc0[dzMBt and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only If billed by a hospital subject to OPPS for an outpatient service, these CPT codes will be paid under the OPPS when the service is not performed by a qualified therapist and it is inappropriate to bill the service under a therapy plan of care. 15004 and +15005 for face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. an effective method to share Articles that Medicare contractors develop. Please subscribe today or login for access. Refer to NCCI and OPPS requirements prior to billing Medicare.For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.The diagnosis code(s) must best describe the patient's condition for which the service was performed. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. When debridements are performed, the debridement . ii. Auto- is different: If you see the term autograft or tissue cultured autograft, then you are dealing with the harvest and/or application of an autologous skin graft. Is this right? In cases of excessive frequency or prolonged duration of treatment, documentation should include an evaluation for possible infection (e.g. %PDF-1.5 % If the documentation supports that 20 sq. Two procedure codes need to be assigned-the excision and the graft closure. 0000017002 00000 n cm and not just that the size of the skin substitute was 20 sq. Bilateral Carpal Tunnel Procedures Different Days, Multiple Laminectomies to Place a Spinal Cord Stimulator. Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contractures ). 1279 0 obj <>/Filter/FlateDecode/ID[<8B4464A13AA9C745B5A6304A9784D76D>]/Index[1253 57]/Info 1252 0 R/Length 97/Prev 314542/Root 1254 0 R/Size 1310/Type/XRef/W[1 2 1]>>stream Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. Replacement material, graft size, multiple wounds all these factors and more [], Dont miss pregnancy impact. Trunk, arms, legs a$EdK@#)6e|y~#5H. Secondary Payor Doesnt Recognize Consultations. CMS has defined "not usually self-administered" according to how the Medicare population as a whole uses the drug, not how an individual patient or physician may choose to use a particular drug. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm cm. Terms: Primary intention means that the edges of the wound or graft are closed to allow them to grow together, while secondary intention refers to allowing an open wound to heal from the base up by building new tissue. The program covers drugs that are furnished "incident-to" a physician's service provided that the drugs are not "usually self-administered" by the patient. Debridement is considered a separately reportable procedure when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue is removed, or when debridement is carried out separately without an immediate primary closure. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. The National Correct Coding Initiative (NCCI) bundles skin substitute graft codes 15271-+15277 with skin and subcutaneous debridement code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less). hVmo6+ER|l%v5/:Bm#e'b|x;CA\X&V@[ ElBdd B()"8$^DHhFTDv):7^L]c"BJ#=,'$T#BJ! View ICD-10-PCS CODING 2022 - Case Studies and Code Building Exercises.docx from HLTH 1241 at St. John's University. If a physician uses a curette to debride slough on the surface of the wound is that classified as subcutaneous or non-surgical? 0000017393 00000 n 39 0 obj <>stream You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. Bilateral Carpal Tunnel Procedures Different Days. For patients with chronic wounds being treated in an outpatient setting, services beyond the fifth surgical debridement, CPT code 11043, 11046 and/or 11044, 11047, per patient, per year, per wound may require a medical review of records demonstrating the medical reasonableness and necessity. Earn CEUs and the respect of your peers. Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). To bill for an Apligraf (HCPCS Q4101) package (equal to 44-sq. Skin Lesion Excision Wait for Pathology? Question: %%EOF End User Point and Click Amendment: CDT is a trademark of the ADA. Can I report 11042 (debridement skin and subcutaneous tissue, first 20 sq cm) and +11045 (each additional 20 sq cm) for the debridement in addition to the split thickness skin graft code? To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom Coding and Billing for Skin Substitute Grafts Skin substitute graft application code selection is based on defect site location and size. A: It depends on the documentation. /| Bill types and Revenue codes have been removed from this article. 0000006208 00000 n CPT codes, descriptions and other data only are copyright 2022 American Medical Association. Contractors may specify Bill Types to help providers identify those Bill Types typically 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. Initial debridement may be deep and through skin, subcutaneous tissue, muscle fascia, and muscle. In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths. Coding matrix for the new skin substitute graft codes For multiple wounds, sum the surface area of all wounds requiring grafts from the same anatomic site and report the applicable primary code and add-on code in multiples, as appropriate. that coverage is not influenced by Bill Type and the article should be assumed to Application of Bioengineered Skin Substitutes and Skin Grafting is performed on ulcers that are free of . These codes are primarily used when irrigation and . rW`n":Q5g%_7:j)j9."QFGH(2My"hqt}%%l}]KkWmNhlI,(PjqK9%.v#|3^ya%h'e'e2iB@iFOk|q)7 If.ug q&QP;jNy>9cW=aB=je>m3/dDQMA;2VJ0E5&Qj2[iG"^l+E. 1 G/r f VY;fuC{r@,>^Q k1[1Q3#V^DJ;;j!E"&~'/;{1M, ~ B ^(\%@%t m+?Rh@yK Even a minor breach of patient protected health information (PHI) or [], Question: We have a new surgeon in our practice who specializes in vascular surgery, and [], Question: When our surgeon rounds on a patient in the critical care unit, can we [], Question: When and how should we use external cause codes? The CMS.gov Web site currently does not fully support browsers with Likewise, the Arobella Qoustic Wound Therapy System uses an ultrasonic assisted curette to debride wounds mechanically. Like the site preparation codes, CPT distinguishes these codes by anatomic site and wound surface area, as follows: o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with CPT codes 11000 and 11001 are not appropriate for debridement of a localized amount of tissue normally associated with a circumscribed lesion. Skin substitute graft application code selection is based on defect site location and size. The medical record should include the following information: The documentation must include that if indicated, ongoing pressure relief has been prescribed, for example, shoe inserts, modifications, padding, frequent position changes, etc. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. 0000010490 00000 n Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. All Rights Reserved (or such other date of publication of CPT). RyfJwE@~:_t4lGY@iYTSBd(m6 DZk0XGxmpP+pF+ff,rBQ*A-E;qkdKom`5!0>?|;!Qb5(Hj QPiX)=Zc4cgQ+*lri59? While every effort has been made to provide accurate and article does not apply to that Bill Type. Peruse CPTs Skin Replacement Surgery section, and youll see that the guidelines mention different types of skin grafts. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not of the Medicare program. Coding Skin Procedures in the Office Setting Written and Presented by Susan Ward, CPC, CPC-H, CPC-I, CPCD, CEMC, CPRC . CPT codes, descriptions and other data only are copyright 2022 American Medical Association. The procedure is essential for wounds that aren . As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. The following procedures are considered part of active wound care management, and are not considered as debridement and are not included in the related LCD: Removal of devitalized tissue from wound(s), non - selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care. trailer <<1D25FBD66AB6418699B8EC89A49470A5>]/Prev 196840>> startxref 0 %%EOF 74 0 obj <>stream 11042 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less + 11045 - each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) It's also done to remove foreign material from tissue. Debridement Codes 11000 -11001 -11000 -Debridement; up to 10% of body surface . Q: I have been trying to determine whether a skin graft includes debridement. The treatment plan for a patient who requires frequent repeated debridement should be reevaluated, to ensure that pressure reduction and infection control have been adequately addressed. CMS believes that the Internet is If your session expires, you will lose all items in your basket and any active searches. The AMA does not directly or indirectly practice medicine or dispense medical services. used to report this service. 0000027593 00000 n When performing debridement of a single wound, report depth using the deepest level of tissue removed. Remember: Wound surface area is what you should consider when selecting the code, not the size of the graft, cautions Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan. Instructions for enabling "JavaScript" can be found here. 465 Wound Debridement and Skin Graft Except Hand, for Musculo-Connective Tissue Disorders without CC/MCC If you miss the separate skin preparation step, youll sacrifice pay your surgeon deserves. A Draft article will eventually be replaced by a Billing and Coding article once the Proposed LCD is released to a final LCD. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. Determining the wound location and surface area is important in order to select the appropriate CPT code. that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. 0000007521 00000 n debridement of a single wound, report depth using the deepest level of tissue removed. Revenue Codes are equally subject to this coverage determination. j0 W0 There are multiple ways to create a PDF of a document that you are currently viewing. Non-autologous human skin (dermal or epidermal, cellular and acellular) grafts, including allografts (from a person other than the patient) and homografts (from cadavers) 0000011160 00000 n Some articles contain a large number of codes. Size: To determine the surface area for code selection, add all areas within the same anatomic grouping, if the surgeon prepares multiple wounds. Appropriate changes in the ongoing treatment plan to reflect the clinical presentation must be present in the record. Please do not use this feature to contact CMS. hbbd``b`J@ H0lV$ W0 y 43 0 obj <> endobj xref In your example, you will be closing the wound. LGXt5q]$]0"$T ?@Z"&&g2~caPa;SS:Sk \SA?3U'VXAHKJ66 R f`p/2XNd@T1 AHA copyrighted materials including the UB‐04 codes and reasonable efforts to provide accurate coding information, this information should not be construed as providing clinical advice, dictating reimbursement policy, or substituting for the judgment of a practitioner. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS, DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), Some older versions have been archived. Youll find the codes for skin substitute graft procedures in the range 15271-+15278 (Application of skin substitute graft ). 1. You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees and agents. This question was answered by Denise Williams, COC, senior vice president of the revenue integrity division and compliance auditor at Revant Solutions in Trussville, Alabama. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. In ICD-9-CM, the Alphabetic Index main term entry is Graft; subterm entry fascia, which directs users to code 83.82, Graft of muscle or fascia. Neither the United States Government nor its employees represent that use of such information, product, or processes Based on what I have read in the Official Guidelines for Coding and Reporting and Coding Clinic for ICD-9-CM, I believe that I should report two separate codes.Otherwise, the graft code would have an includes note indicating the debridement is inherent in the code. MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. Service: The work described by these codes involves preparing a clean, viable wound surface for graft placement to heal by primary intention (not secondary intention). If more than 44-sq. An official website of the United States government. cm or less). 0000036033 00000 n Identification of the wound location, size, depth and stage either by description and/or a drawing or photograph. 0000020105 00000 n Any other conditions that may significantly affect wound healing should also be appropriately addressed in the medical record. Current Dental Terminology © 2022 American Dental Association. Would also adding Mod 22 help, and for which one 11042 or 11043? 15271-15278 is the new CPT code series for skin substitute grafts. Table 2 summarizes the coding matrix for the new skin substitute graft codes. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. 0000000016 00000 n Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. Include cleaning: When the surgeon performs a simple cleansing of the wound, that service is included within the skin substitute procedure codes, according to CPT instruction. Applications are available at the American Dental Association web site. 43 32 0000000936 00000 n twZ5C2ayV`C~1S6#9mOk)d4sr$#yd:W8 Eu1EgZ \ 0 E endstream endobj 49 0 obj <>stream 25 0 obj <> endobj 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. endstream endobj 1254 0 obj <>/Metadata 102 0 R/OCProperties<>/OCGs[1280 0 R]>>/Outlines 119 0 R/PageLayout/SinglePage/Pages 1245 0 R/StructTreeRoot 186 0 R/Type/Catalog>> endobj 1255 0 obj <>/ExtGState<>/Font<>/Pattern<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 1256 0 obj <>stream In your case, the wound is being closed with a split thickness skin graft so the debridement codes are not accurate in this situation. The American Hospital Association ("the AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. *4 Use CPT code 15340-15341 or CPT code 15360-15366 for the surgical preparation or creation of recipient site for the tissue skin graft. You can collapse such groups by clicking on the group header to make navigation easier. In most instances Revenue Codes are purely advisory. o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children) The views and/or positions The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, Draft articles are articles written in support of a Proposed LCD. 1309 0 obj <>stream Applicable FARS\DFARS Restrictions Apply to Government Use. As you can see, procedure code 86.69 (other skin graft to other sites) includes the debridement and closure of the amputation site via split-thickness skin graft. cm. Complete documentation for excisional debridement requires five elements, including: i. What does Separate Procedure Mean in a CPT Code Description? Sometimes, a large group can make scrolling thru a document unwieldy. The patient's medical record must contain documentation that fully supports the medical necessity for services included withinthe related LCD. iii. Skin substitute grafts include the following: Avoid: Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. Therefore, the more accurate code is a surgical preparation code (15002 15005) for excision (note the term is not debridement) of the open wound to prepare a viable wound surface for grafting. Article document IDs begin with the letter "A" (e.g., A12345). (application of skin substitute graft to, for example, leg or ankle). Peruse CPTs Skin Replacement Surgery section, and youll see that the guidelines mention different types of skin grafts. If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). v. The depth of the debridement (e.g., to skin, fascia, subcutaneous tissue, muscle, or bone). and monitoring is occurring. Non-excisional debridement (e.g., 97602 Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session) is described as nonsurgical because it does not involve cutting away or excising devitalized tissue. Codes describing excision debridements deeper than skin only are organized by depth: 2. K;7@J3"(>6&/~!.]wWV~- *h"BQ"H" 5=QHpI8$ {Lz 4. 0000016569 00000 n Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In your example, you will be closing the wound. For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. 11012 skin, subcutaneous tissue, muscle fascia, muscle and bone. CMS and its products and services are not endorsed by the AHA or any of its affiliates. This page displays your requested Article. If the provider is unable to use photographs for documentation purposes, the medical record should contain sufficient detail to determine the extent of the wound and the result of the treatment. This code is based on a wound size (singular or aggregate size; after cleansing, prepping, and/or debriding) minimally of 100 sq cm*. Answer: Your coder is correct simple debridement is included in the graft codes. . Instructions for enabling "JavaScript" can be found here. Face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/ or multiple digits 0000018702 00000 n 5. If the wound is being excised, not just debrided, at the time of split thickness skin graft placement then you could also report a surgical preparation code (e.g., 15002, 15004) in addition to the skin graft code. Also, you can decide how often you want to get updates. +etUfqVW7]?5P .kJXp. Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. Tech & Innovation in Healthcare eNewsletter, Excision of Benign or Malignant Skin Lesion, Reporting Debridement Requires Documented Area and Depth, Both Depth and Area Matter when Reporting Debridement, Meet Documentation Criteria for Excisional Debridement, subcutaneous tissue (includes epidermis and dermis, if performed) 11042, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed) 11043, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed) 11044. That means you should never report 97602 (Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session) in addition to skin graft site preparation codes. Skin Lesion Excision Wait for Pathology? hUmo0+q 0HUmIkN^D Wk$$[n;=AIWq@ All rights reserved. Copyright 2023, AAPC Codify Subscriber Answer: You should [], Copyright 2023. You can use the Contents side panel to help navigate the various sections. cm; we know that many times the actual size of the skin substitute is larger than the area that was covered. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. uKEmc2vy5\^gB:w76>9s=gKn4"=yJ} crv[d[ ML\:6q~6U6_Nc8Dc?nN8^>\RY[qZ{XO*JT!e,(7=m]7}}O@gSS(B"t658>~.%W['i9hch8bQT%ml Photographic documentation of wounds either immediately before or immediately after debridement is recommended for prolonged or repetitive debridement services (especially those that exceed five extensive debridements per wound (CPT code 11043 and/or 11044)). 0000004501 00000 n Absence of a Bill Type does not guarantee that the 0000030507 00000 n If you do not agree with all terms and conditions set forth herein, click below on the button labeled "I do not accept" and exit from this computer screen.