Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > General Discussion
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 05-05-2012, 02:24 PM
lopezk89's Avatar
lopezk89 lopezk89 is offline
Networker
 
Join Date: Apr 2007
Location: Albuquerque,NM
Posts: 59
lopezk89 is on a distinguished road
Question How would you code this..... Diabetic Ulcer Debridement

I am having some issuse with codeing this I have looked at evrything in the case studie and can not figure it out I get it wrong every time....I need the CPT and ICD 9 Codes for this .Debridement of 16 sq. cm. subcutaneous tissue and muscle due to diabetic foot ulcer. I have 11042 and diagnosis of 249.80 and 707.15 Can some one help please
Reply With Quote
  #2  
Old 05-05-2012, 06:09 PM
ollielooya ollielooya is offline
True Blue
 
Join Date: Apr 2007
Location: Everett, WA
Posts: 710
ollielooya is on a distinguished road
Default

Hi, just wondering if perhaps your choice of CPT code might be reconsidered, since your note states it involves BOTH tissue and muscle and the 11042 denotes subcutaneous tissue. Dig a little deeper into the code classification. Hopefully, others will comment and set us both straight?
__________________
Suzanne E. Byrum CPC
Noridian
NGS
Reply With Quote
  #3  
Old 05-05-2012, 07:49 PM
espressoguy espressoguy is offline
Guru
 
Join Date: Apr 2007
Location: Tacoma, WA
Posts: 137
espressoguy is on a distinguished road
Default

If it were me, I would probably code 11043 since muscle is mentioned with a dx of 707.14 primary and 250.00 secondary.
__________________
L. Mark Kozu, CPC, CPC-H
Coder/Abstractor II
Cardiology, Wound Care & Podiatry
UW Medicine / Valley Medical Center
Renton, WA

Last edited by espressoguy; 05-05-2012 at 07:51 PM.
Reply With Quote
  #4  
Old 05-07-2012, 08:18 AM
Cyndi113's Avatar
Cyndi113 Cyndi113 is offline
True Blue
 
Join Date: Apr 2007
Location: Phoenix, AZ
Posts: 613
Cyndi113 is on a distinguished road
Default

Use 250.8x as the DM code. Read both your ulcer and 250.8x additional code instructions.
__________________
Cyndi Allen, CIRCC, CPC
Reply With Quote
  #5  
Old 05-07-2012, 10:48 AM
ollielooya ollielooya is offline
True Blue
 
Join Date: Apr 2007
Location: Everett, WA
Posts: 710
ollielooya is on a distinguished road
Default After re-reading the initial post

Glad there have been some additional responses. I noticed that the poster had listed 249.80 as the diabetes code. Again, you might want to re-examine your choices as thie is the category for secondary diabetes mellitus. Just a thought...
__________________
Suzanne E. Byrum CPC
Noridian
NGS
Reply With Quote
  #6  
Old 05-07-2012, 10:50 AM
mitchellde's Avatar
mitchellde mitchellde is offline
True Blue
 
Join Date: Apr 2007
Location: Columbia, MO
Posts: 8,328
mitchellde will become famous soon enoughmitchellde will become famous soon enough
Default

[quote=lopezk89;218971]I am having some issuse with codeing this I have looked at evrything in the case studie and can not figure it out I get it wrong every time....I need the CPT and ICD 9 Codes for this .Debridement of 16 sq. cm. subcutaneous tissue and muscle due to diabetic foot ulcer. I have 11042 and diagnosis of 249.80 and 707.15 Can some one help please[/QUO
249.x is for secondary diabetes. From ehat you have provided there is nothing to indicate secondary diabetes. Therefore you must code the 250.80
As the first listed code with the 707.1x secondary.
To the poster suggesting the 707.15 first with 250.00 secondary:
When documentation ststes the ulcer is diabetic or due to or eith the disbetes then the diabetes codeust be first listed wit a 4 th digit other than 0 for the complication. I would need a procedure note for the CPT code.
__________________

Debra A. Mitchell, MSPH, CPC-H

Last edited by mitchellde; 05-07-2012 at 10:53 AM.
Reply With Quote
  #7  
Old 05-07-2012, 10:55 AM
lopezk89's Avatar
lopezk89 lopezk89 is offline
Networker
 
Join Date: Apr 2007
Location: Albuquerque,NM
Posts: 59
lopezk89 is on a distinguished road
Talking Thank You Everyone

I have Figured it out with your help ... That little bit info was what was given to me to code from that's why I think I was having some much trouble and the 11042 and the 707.15 and 250.80 where the codes that I needed thank you again ....
Reply With Quote
  #8  
Old 05-07-2012, 02:44 PM
solocoder solocoder is offline
Guru
 
Join Date: Apr 2007
Location: Springfield, Mo
Posts: 144
solocoder is on a distinguished road
Default

Medicare, however, wants the DM with manifestation codes listed the other way round. 250.80 first, followed by 707.1X.
__________________
Ruth Gaeke, CPC
Reply With Quote
  #9  
Old 05-07-2012, 02:50 PM
mitchellde's Avatar
mitchellde mitchellde is offline
True Blue
 
Join Date: Apr 2007
Location: Columbia, MO
Posts: 8,328
mitchellde will become famous soon enoughmitchellde will become famous soon enough
Default

That is not just Medicare. The diabetes with manifestation code is always first listed according to the coding guidelines.
__________________

Debra A. Mitchell, MSPH, CPC-H
Reply With Quote
  #10  
Old 05-10-2012, 03:16 PM
isabel.bickle@yahoo.com isabel.bickle@yahoo.com is offline
New
 
Join Date: Apr 2007
Posts: 2
isabel.bickle@yahoo.com is on a distinguished road
Default Medicaid Analyst

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. Since the submitted information does not indicate the type of diabetes or if it's controlled or not, use 250.80 (type II or unspecified, not stated as uncontrolled) as the primary diagnosis. If the chart note indicates a specific part of the foot, use the most appropriate code in the 707.1x series.

This is what I would code: 11043 with 250.80, 707.15
________________________________
Isabel Bickle, RN, BSN, CPC
Medical Policy Analyst
Division of Medical Assistance Programs
Salem OR
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 02:27 AM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC