Wiki Extensive wound debridement

[emeskina]

My doc does a lot of chronic wound care for patients with large decubitus ulcers and other necrotic wounds. The areas he has to debride are sometimes very extensive and the procedures are quite time consuming . Generally 2-3 serial debridements are needed before grafting and closure can be considered. The codes available 11040-11044 and 15002-15003 do not adequately represent the extent of the work he is doing. Is there anyone out there that has had experience with this? If so, how are you coding out these services? Also I would like to know different opinions on the correct usage of the 15002-15003 codes. Can they be used for serial debridements or explicitly in preparation of immediate grafting in the same session?

Thanks in advance for your help! Erin

 

[rjconnell]

I can't speak to ulcers, but I can help with necrotic wounds. For large areas of skin you can use 11000 and 11001. Don't let the "eczematous" throw you off. There is an "or" infected skin. Also specifically for necrotic wounds of abdominal wall, perinium or external genitalia are the codes 11004 to 11006. Your physician must document that it is necrotic and that it was debrided to the muscle, but the RVUs are much higher than 11043 debrided to muscle.

 

[haadi]

for decubitus ulcer debridement take the code from 15920-15999 series & for necrotic debridement 11004-11006 but for that there has to be documentation suggesting the necrosis.

thank you.

 

[LMBOTT]

Does the provider also try to bill an E/M level? I am having a problem with some provider education.

Thank you,

Lisa Bott CPC, CPC-H