Wiki 00630 vs 01120

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RhondaMB

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We have raised a question in our office regarding a debridement of a sacral ulcer to the bone with no closure using code CPT 11044.

The crosswalk refers to ASA 01120 whereas 00630 has the following comments:
"RVG comment: Includes procedures on sacrum" and
"RVG Comment: Code 00630 describes anesthesia for open procedures in the lumbar/sacral region."

Our debate is which is a better choice for a debridement of a sacral ulcer (please keep in mind this is not an excision of a sacral ulcer) 00630 or 01120.

Would love to hear reasoning and guidance towards using correct ASA.

Thanking you in advance for your help in this discussion.
 
01120 is the correct code for this.

First, 00630 is listed under the heading Spine and Spinal Cord, but the procedure you are describing debrides skin, muscle and bone. It does not involve the spinal cord. Second, even though this is not an "Excision" of a sacral ulcer, it is similar in work. The sacral ulcer excision codes all cross to 00300 or 01120 depending on the depth of the procedure. 00630 is used for procedures that are more in depth and a higher risk. It would not be appropriate for a sacral ulcer debridement.
 
Debride: To remove dead, contaminated, or adherent tissue and/or foreign material. To debride a wound is to remove all materials that may promote infection and impede healing. This may be done by enzymes (as with proteolytic enzymes), mechanical methods (as in a whirlpool), or sharp debridement (using intruments).

Excision: 1. Surgical removal, as in the excision of a tumor. 2. The removal as if by surgery, as in excision of a tumor; implying at least partial, if not complete, removal.
 
ASA 01120 would be the correct code of choice since it clearly says as "Anesthesia for procedures on bony pelvis" which include ilium, ischium, pubis, sacrum and coccyx whereas ASA 00630 is applicable for lumbar procedure (not otherwise specified)

Thanks,
Vernon Kreiss
 
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