Wiki At a Complete loss for coding this procedure

[AR2728]

My General Surgeon and I sat down together in an attempt to code the following and couldn't locate anything--I would appreciate any help!

The surgeon did a complex scalp repair on a 13 cm total laceration, the laceration extended down to the bone with a 3 cm groove4 inthe outer shell of the bone and a 3-4 mm fracture anterior of the outer shell of the calvarium and did fracture the outer shell down into the marrow. The surgeon debrided the fractured bone and irrigated the area with antiobiotic solution, then proceeded with closure.

The repair/closure I am having no problem coding, the issue is the bone debridement. Any suggestions?

 

[poonamsawant]

Bone Debridement

Hi,

I can only think of 11044, Deb till Bone. As this is included in complex repair scalp code, the case will be finally assigned 13121, 13122 X 2 - 873.1
acording to me.

Can anyone please confirm this.

Thanks
Poonam

 

[FTessaBartels]

Fracture down into the marrow

GREAT question!
NOT my area of expertise ... but ...

Option 1 ...You say the fracture was down into the marrow. How about 11012 - debridement associated with open fracture?

Option 2 ... I looked at 62000 as well, but I don't think (from the brief description you gave) that fits ...
although perhaps with a -52 modifier?

In either case above you wouldn't code for the repair, as it would bundle into the procedure.

Option 3 ... 21499 Unlisted Musculoskeletal Head ... for just the fracture work.
And then ...13121 + 13122 x 2

Option 4 ... 13121 -22 modifier + 13122 x 2

For all of these options I'd add the dx for the skull fracture as well.

Hope that helps ... As I type it I keep asking myself more questions ...

F Tessa Bartels, CPC, CEMC