Wiki Debridement denials 10005 & 10008

sharonc2222

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During an intrathecal baclofen pump replacement, the surgeon says he completed a debridement and coded as 11005 & 11008. Medicare denied both, saying 10008 did not have a qualifying claim or service and 11005 for being incompatible with another code. Below is a clip from the operative note. Any ideas on the proper coding here?

Attention was first turned to the abdominal incision. Incision was made using a scalpel. Dissection was carried down to the level of the pocket using monopolar cautery. Upon entering the pocket, a yellow white slightly viscous fluid was encountered. The fluid was swabbed and sent for stat Gram stain and culture. The pocket was then entered and the pump was explanted from the pocket. The pump was then placed in an antibiotic solution. Upon inspection, the catheter was noted to be intact through the connector sites in between the pump catheter and the lumbar catheter. The side port was accessed using a 3 mL syringe and a Huber needle and clear CSF was aspirated with some difficulty, showing that the catheter was patent. The lab called back and stated that the fluid did not have any organisms or leukocytes making the risk of infection low. Therefore, given the fact that the catheter was functioning and the pump was not infected, decision was made to reimplant the pump. The current Medtronic SynchroMed II pump that was soaked in antibiotic solution was then reimplanted. All the fluid was copiously irrigated out with antibiotic solution as well as suctioned away. The pump was then re-primed and filled with baclofen and attached to the current catheter system. Clear CSF was noted to be egressing throughout the whole system. The new pump then was attached to the catheter system and with aspiration of the sites very easily.
 
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