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#1
05-05-2012, 02:24 PM
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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
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#2
05-05-2012, 06:09 PM
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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?
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Suzanne E. Byrum CPC Noridian MCR-WA WPS MCR-Illinois
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#3
05-05-2012, 07:49 PM
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If it were me, I would probably code 11043 since muscle is mentioned with a dx of 707.14 primary and 250.00 secondary.
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L. Mark Kozu, CPC, CPC-H Coder/Abstractor II Wound Care, Podiatry, Cardiology, and Vascular UW Medicine / Valley Medical Center Renton, WA Last edited by espressoguy; 05-05-2012 at 07:51 PM.
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#5
05-07-2012, 10:48 AM
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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...
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Suzanne E. Byrum CPC Noridian MCR-WA WPS MCR-Illinois
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#6
05-07-2012, 10:50 AM
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[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
[/QUO249.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.
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Debra A. Mitchell, MSPH, CPC-H 
Last edited by mitchellde; 05-07-2012 at 10:53 AM.
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#7
05-07-2012, 10:55 AM
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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 ....
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#9
05-07-2012, 02:50 PM
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That is not just Medicare. The diabetes with manifestation code is always first listed according to the coding guidelines.
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Debra A. Mitchell, MSPH, CPC-H
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#10
05-10-2012, 03:16 PM
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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
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