Wiki Complex repair revisited

[lshannon]

I have reviewed all the posts on complex repairs but didn't see this issue addressed.

I started coding for a new surgeon and he is insisting that an excisional debridement before a repair ALWAYS constitutes a complex repair. I see no differentiation for excisional debridement in CPT, and sometimes his documentation doesn't even indicate a layered closure even though he's done an excisional debridement.

Can anyone clarify for me?

Thanks in advance....
Lynn

 

[FTessaBartels]

CPT Guidelines

Without seeing the actual documentation it is hard to answer correctly. But read the CPT Guidelines for Repair (Closure) - in the 2010 CPT Professional Editition, these are on page 64.

Complex repair includes the repair of wounds requiring more than layered closure, viz., scar revision, debridement (eg. traumatic lacerations or avulsions), extensive undermining ... (emphasis added by FTB)

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[lshannon]

Yes, I read the guidelines, I guess I didn't phrase my question correctly. This doc does a debridement, usually excisional, before all repairs. Not all these injuries are traumatic or complicated. Does the fact that the doctor documented the debridement provide enough "proof" that the repair can be coded as complex?

Thanks!