Orthopedic Coding Alert

Question: One of our patients had bilateral pilon fractures with compartment syndrome requiring fasciotomies, staged debridements, and unilateral skin grafting. Following his hospital release, the patient required extensive dressing changes, including minor tissue debridement and irrigations. Are these services going to be reimbursable?

Alaska Subscriber Answer: Dressing changes are only billable if the physician performs them on a patient who is under general anesthesia. If this is the case, you can report 15852 (Dressing change [for other than burns] under anesthesia [other than local]). If not, the dressing changes are bundled into the surgeries that you performed.
 
You can, however, report the debridement using the appropriate code from the 11040-11044 series. You should append modifier -58 (Staged or related procedure or service by the same physician during the postoperative period) to ensure that the payer doesn't bundle it into the surgical procedure.