4 Quick Tips for Debridement Coding

1. Codes describing excision debridements deeper than skin only are organized by depth:

  • 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)
  • muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed) – 11043 Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less and 11046 … each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
  • bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed) – 11044 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less and 11047 … each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

2. Complete documentation for excisional debridement requires five elements, including:

i. A description of the procedure as “excisional”

ii. A description of the instrument used to cut or excise the tissue (e.g., scissors, scalpel, curette)

iii. A description of the tissue removed (e.g., necrotic, devitalized or non-viable)

iv. The appearance and size of the wound (e.g., down to fresh bleeding tissue, 7 cm x 10 cm, etc.)

v. The depth of the debridement (e.g., to skin, fascia, subcutaneous tissue, muscle, or bone)

If any of these elements is missing, documentation does not meet the criteria for excisional debridement. Note that debridement of the skin that is preparatory to further surgery, such as reduction of fracture, should not be coded as a separate procedure.

3. 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. 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. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate.

4. 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. Rather, it is removal of devitalized tissue, necrosis, and slough by other methods, including:

  • Scrubbing
  • Washing
  • Water scalpel (jet)
  • Irrigation (under pressure)

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.

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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 404 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

2 Responses to “4 Quick Tips for Debridement Coding”

  1. govind says:

    pls help me whether to code manually debrided ones.

  2. Amy says:

    If a physician uses a curette to debride slough on the surface of the wound is that classified as subcutaneous or non-surgical?

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