wound care

  1. S

    Question Wound Care

    I have a wound care question, I work with a wound care provider twice a week, he has always included a 99214(or applicable OV code) with his wound care codes, he has done wound care for a long time, he is now being told that after the first visit with the patient the only code is the...
  2. L

    Question Wound Packing without I&D by different provider

    I have a patient that had an I&D by a different provider, in fact a different health system all together. My doc saw this patient for repacking/dressing change. Anyone have a clue what CPT code I could use for this other than E/M?
  3. M

    Question Are we able to append modifier 59 if skin substitute and application is billed with E/M

    I work for a wound care clinic that often bills skins substitutes on the same date as an evaluation or other E/M codes. So I would like to know the proper way to bill this. Should we bill 992**-modifier 25, Q41**- modifier 59 and application 152**- modifier 59. Is this the correct way to bill this?
  4. M

    Question Application of free (pro bono) skin substitutes for Medicare.

    I work for a wound care clinic that applies free samples given to us by pharmaceutical rep to patients. I wanted to know if there's a way to receive reimbursement from Medicare for the application only. If so, how would I bill this? I attended a seminar that stated that modifier "FB" was...
  5. M

    Can we bill E/M codes on every routine wound care visit?

    I work for a wound care clinic that happens to also offer Hyperbarics treatment to patient with non healing diabetics wound, cosmetic abdominoplasty, hypospadias etc. Now I would like to know if the provider is able to bill and E/M code on every routine wound care visit. For example, patient...
  6. K


    Patient was seen in our OR for EXCISION PILONIDAL CYST/SINUS COMPLICATED. The patient follows up weekly for wound care treatment. The wound clinic is in the same hospital as the OR and is being done by the same physician. The note states: "HPI: Patient presents to office for followup wound...
  7. M

    Wound Care and Wagner staging

    Really need a wound care coder for networking. How do I assign ICD-10 dx code to a Wager stage description. Please email. Thank you
  8. J

    Billing 12021 for wound care.

    I have a provider who keeps using CPT 12021 for packing a wound. My reading of the description tells me that this code is for wound dehiscence (for example, if sutures were removed & the wound split open, or an infection/abscess developed behind a surgical incision and kept it from healing)...
  9. A

    11042-11047 Area of Partial Debridement

    Good Afternoon Everyone, This is my first post and question, I apologize if it is in the wrong forum section. My question is in regards to measuring the area of a debridement. From what I have read, it is measured by the "depth and the surface area of the wound". My question is what if only...
  10. B

    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...
  11. G

    Dog Bite Wound Care

    Need a little clarification on coding a Dog Bite. We have a Healthcare office & Urgent Care all in one. This one came in under urgent care. Here is the notes from the encounter: Location: right lower leg posterior calf region. The wound was irrigated with sterile normal saline and debrided...
  12. L

    Debridement and Unna/Compression CPTs for different wound conditions

    I'm hoping you all can help me find some documentation that I've lost. My research found that if I have a Venous Insufficiency ulcer, I can code Debridement AND Unna/Compression with a -59 modifier because the Debridement is for the ulcer and the Unna is for the separation condition for the...
  13. S

    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...
  14. J

    Ulcer wound care (debridement) and office visit

    I understand the modifier 25 issue - however, my doc's are concerned that when pt's are coming into our office for wound care (debridement of an ulcer) that they are losing money by not being able to bill an office visit with it. I have explained what the modifier means to them, but, their...
  15. D

    Excision of mass with closure/ complex repair

    The billing comes over marked 21933, 13101/59, 13102/59. A mass was removed the patient's flank, fine, but the surgeon has underlined this in the chart: A direct approximation of closure was not possible without creating significant additional deformity. Extensive undermining of skin and...
  16. B

    Wound Care Center

    I have been researching for specific info on billing when services are rendered in a Wound Care Center. My MD will be going to a Wound Care Center once a week for possible debridements to patients, could I still use the codes 11042-11047 with POS 11? POS 22? POS 49?
  17. K

    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...
  18. S

    Wiki PLEASE HELP! Radiation soft tissue injury of the brain ICD-10 code(s)

    I am having trouble determining the correct ICD-10 diagnosis code(s) for "Radiation soft tissue injury of the brain". One of my providers is treating a patient for this condition with hyperbaric oxygen therapy. He also refers to the condition as "Radiation therapy induced brain necrosis". I have...
  19. C

    Wound Care Billing - Are there any (very) experienced

    Are there any (very) experienced or expert wound care coders available today for questions? I'm a experienced coder working in some new areas, one of which is wound care.