confused - I have an excision of a 6 cm

[tdbear612@yahoo.com]

I have an excision of a 6 cm carbuncle, deep disection with debridement of edges with metallic curette and packing.
Would this be a 10061 with 11012, or a 11406 and 11012????

 

[Akulo]

This is just my speculation.

I would think you'd only bill it as debridement coding depending on depth. you only use 11012 if the bone is involved (I think) and if you're removing foreign material (say a building blew up next to the patient and a shard stabbed his/her leg and the doctor had to remove the shard and also remove devitalized tissue) so I doubt you'd use that code.

I don't think a carbuncle is considered foreign material. Maybe 11042 or 11043 depending on the depth since I'm assuming the devitalized tissue is due to a bad infection from the carbuncle. I would think 11042 or 11043 includes payment for the removal of the carbuncle if debridement was done at the same time assuming it was a necrotic carbuncle or something. (would help if you had the operative note)

 

[tdbear612@yahoo.com]

re

Thank you Jesse, I just want to make sure our doc gets payment for all he does, he really does spend time with all his patients.

 

[Akulo]

Thank you Jesse, I just want to make sure our doc gets payment for all he does, he really does spend time with all his patients.

You may also want to consider the codes for benign excision with "complex repair" instead, assuming that a repair was done.

You only mention an excision and debridement done but no repair, but I'm assuming a repair would be done after the carbuncle was cut out?

I didn't realize before but a complex repair code includes debridement. Assuming that a repair was done with debridement.

This seems to make more sense since the "intent" seems to be to excise the carbuncle not debridement, and when you cut out something you usually have to do a repair right? (simple, intermediate or complex) This seems like it could fall under Complex repair.