1. P

    Wiki 97597 for burn wound?

    Have a physician who performed 97597 (not 11042) at a burn site. Is 97597 still correct or would this be 16000's level code Instead?
  2. L

    Wiki Post Op Wound

    If the patient's incision develops a wound postoperatively (90-day global) and comes into the office weekly for wound care, can we bill for the debridement? Or is this considered part of the global package? Even though it's a complication and requires the patient to come in more frequently than...
  3. A

    Wiki E/M with Debridement in Wound Care Clinic

    Hello, Does anyone have further clarification on when it is appropriate to bill an E/M with a debridement performed on the same wound and in office, pos 11. Guidelines state they can be billed if a reasonable and necessary office visit is provided and is separately identifiable from the...
  4. M

    Wiki Debridement "Down To"

    Hello, How are you guys coding debridements when the documentation states "down to"? Findings: Frankly necrotic tissue extending along the left buttock with tunneling down to the level of the muscle. Cautery excisional debridement performed down to healthy tissue at the level of the muscle...
  5. W

    Wiki 28003/28005 with 28120, 28122, 28222, etc

    I am new to podiatry coding. There is a physician billing 28003 and 28005 (which are NCCI bundled with the following)... 28122, 28062, 28222, 28120.... Mostly diabetic foot infection procedures for debridement/incision and drainage. Is it appropriate to bill the incision portion of the...
  6. N

    Wiki Bundled Office Visit w/ -25

    We have been getting denials recently from Humana when billing 99214-25 (I70.233, F17.218, I89.0) 11042 (L97.312, L97.212, T81.31XA) Dx are different for each code. Only thing I can think of is the i70.233 and L97 codes both address the 'right leg' .. BUT we have been getting paid before with...
  7. J

    Wiki Achilles Tendon Debridement With Topaz-

    Has anyone used 28008 for Achilles Tendon Debridement? The surgeon coded 28008 but I everything I have read looks at 27680- She did not repair, it was not ruptured. She did use Topaz.
  8. A

    Wiki Excisional vs Selective debridement

    We have a new provider to our Wound care program and the documentation has us disagreeing on what type of debridement should be billed. The use of term selective has wound staff stating all debridement's are 97597...but yet, she states excisional and to bleeding tissue...... After application...
  9. G

    Wiki Incomplete procedure note

    We are receiving an MUE edit/denial for this visit. Facility side coded: 99253 11043 1unit 11046 32units Clinical (professional fees) side believes this coding is incorrect - no mention of excisional, no mention of instrument used for I&D or debridement (should not be billed/coded without this...
  10. C

    Wiki extensive debridement of shoulder 29823

    I have a surgeon that is pushing the issue of billing CPT 29823, arthroscopic debridement, extensive with nearly every arthroscopic procedure of the shoulder he performs. I have shown him the NCCI manual section that addresses this, CMS NCCI manual states, “With three exceptions, shoulder...
  11. C

    Wiki Selective Debridement Crosswalk

    Hello, I work for a wound care company that provides services in many different settings. I am looking to map Selective Debridement CPT (97597) to ICD-10 PCS Codes. When referencing the book, it wants me to distinguish between Excisional and Non-Excisional. I know that most Sharps debridements...
  12. Y

    Wiki Debridement question

    Hello, I have the following codes for this case: 11042 – Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less 11045 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof...
  13. S

    Wiki Hand infection debridement

    Does anyone know what the appropriate CPT code would be for an irrigation and debridement of deep palmar infection of the hand? OP report says: "First, I slowly cleaned the hand of chronic purulence that was stuck into the palm. Despite a preoperative scrub and sterilization, there was still...
  14. B

    Wiki Surgery Coding Question-Fractures and Fixators

    I am trying to code this op report and I think I'm trying to make this too hard. Can someone please assist? I thinking 11012x2 for the open fracture debridement and 20693 for the removal and reapplication of the external fixator? PRE-OP DIAGNOSIS: Open fractures right distal radius and distal...
  15. B

    Wiki Epifix Application and Debridements

    We recently started using and billing Epifix in our wound care facilities. We use 15271 and 15272 (add on) as the application codes, with Q4131 as the product code. Our provider was wondering if debridement codes such as 97597, 11042, 11043, or 11044 could be billed with these codes or if they...
  16. K

    Wiki documentation of ulcer sizes with debridement

    Is there any guidelines stating if an ulcer size needs to be documented before or after debridement? My General Surgery office documents size prior to debridement but a coworkers Plastic Surgeon office documents size after debridement. Or should they both be documenting before and after sizes...
  17. S

    Wiki PLEASE HELP - Pre and post debridement measurements with callus

    I have providers in a podiatry clinic who are documenting 0 x 0 x 0 sq cm as the pre-debridement measurements when a callus is overlying an ulcer and then they document the size of the underlying ulcer post-debridement. They state that they cannot measure the wound before the debridement, since...
  18. K

    Wiki Surgical and selective debridement documentation requirements

    I'm auditing both surgical and selective debridement procedures (CPT11042-11047, 97597, 97598) and am finding the wound size is always documented, however it varies or is unclear if this measurement occurs before beginning the procedure or after the completion of the debridement. Is there a...
  19. K

    Wiki Direct to Spacer Hip Case

    I am in touch with a doctor who is asking me for the correct codes for a direct to spacer case, which he does not think he has ever done before. He said it could also theoretically be an arthrotomy hip for debridement with placement of abx spacer code as well. He says they are technically...
  20. K

    Wiki Shoulder scope help!!

    Hello, I have a doctor that does a lot of shoulder scopes. He generally does a subacromial decompression with most of the procedures. My question is would I bill the 29826 or 29823 if other debridement was performed along with the subacromial decompression and parent code i.e 29827 or 29824...
  21. L

    Wiki Coding Burns and Debridement

    Please help with the following note. I am not sure which CPT code I need to use for the debridement. I would also like to verify my ICD 10 codes. This is my first time to code burns. The ICD 10 codes I have for the burns are: T20.10XA, T22.231A, T24.231A, X04.XXXA, W40.1XXA. Any help would be...
  22. L

    Wiki Coding of burns and debridement

    Please help with the following note. I am not sure which CPT code I need to use for the debridement. I would also like to verify my ICD 10 codes. This is my first time to code burns. The ICD 10 codes I have for the burns are: T20.10XA, T22.231A, T24.231A, X04.XXXA, W40.1XXA. Any help would be...
  23. C

    Wiki Help w/ difference in 29822 (limited) and 29823 (extensive)

    Hi, I'm hoping someone can assist me with a chart and show whether 29822 or 29823 would be the appropriate code. I've read thru multiple forum posts, but most are from 2009 and I'm not sure how accurate the information is any longer, and some links didn't work that were attached. I've also read...
  24. R

    Wiki Question regarding Debridement coding and NCCI Edits

    Hello, I am a coder at a small billing company and one of our clients specializes in debridement procedures. According to a recent update in NCCI Edits, the codes 97597 and 97598 can't be coded together. We think this is the result of a very recent change in CPT and there is a different code...
  25. L

    Wiki pip joint debridement- please help

    I am not sure whether or not to bill this procedure here or not..... I have captured the ganglion excision but could you please advise me as to what code would be most appropriate for debridement in this case? I was directed to use 26110 but I am not sure that is correct because there was no...
  26. N

    Wiki Exploration and debridement of nonhealing abdominal wound?

    I need help with a CPT code. I will attach the OP report. He wanted to bill 20102 and I know that is incorrect but I couldn't find anything else to bill. Any pointers? PROCEDURE: Exploration and debridement of nonhealing abdominal wound. Excision of abdominal stitch abscess...
  27. C

    Wiki 29823 with 29824

    29823 arthroscopy shoulder surgical with debridement extensive : is bundling with 29824 (mumford) I have used a modifier 59 and operative does support the debridement , however my denials are still upheld , I donot see any edits that say that its inclusive
  28. D

    Wiki 29877 and 29822

    Hi i am new to orthopedic billing does anyone know if 29822 (limited debridement) is included in 29877arthroscopy shoulder for rotator cuff thank ou
  29. B

    Wiki Arthroscopic Elbow Codes - 29836 or 29838 or BOTH?

    My provider performed a four portal arthroscopic elbow procedure--right elbow extensive arthroscopic debridement and excision of posterolateral synovial plica . This is the clinical description of the procedure (from Medicare GCPI): "The physician performs elbow arthroscopy with the patient in...
  30. J

    Wiki Nail Debridement for Hospice Patient

    We bill for a podiatrist who sees patients in various nursing facilities. Among those patients are some in hospice. For a diabetic Medicare patient we are coding a 11720 or 11721 with the Q-modifier, GW modifier, PCP and date last seen by PCP. Medicare is flatly denying all of our nail...
  31. T

    Wiki Irrigation and debridement of post wound