How can this be coded?

Deb Pugh

Contributor
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Flagstaff, AZ
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We had a patient who wrecked on her 4 wheeler. She came in repeatedly to have the wound checked to and on one visit she saw our nurse who has a Masters in Wound Care. She cleaned the wound with normal saline and removed 2 foreign bodies (wood splinters) with tweezers. How can this be coded?:confused:
 

Pam Brooks

True Blue
Local Chapter Officer
NAB Member
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South Berwick, ME
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FB removal includes an incision, not just picking out debris with tweezers. Wound care guidelines are very specific, so it doesn't matter if your nurse is a wound care expert, it matters what she actually did. Those wound care codes include selective excisional debridement down to deeper levels of skin and subcutaneous tissue, muscle and/or bone, so what you are describing is not wound care for the purposes of the codes in the integumentary and medicine sections of CPT.

Basically, (without seeing the note), I'd simply bill an E&M visit, unless you're bumping up any other 10-day global procedures that you haven't mentioned.
 

mshay134

Networker
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Lincoln, RI
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I noted that in your post, you mentioned that the patient was seen by a nurse. If this is not a nurse practitioner and the physician was not present, then you can only code 99211
 
Messages
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Joliet, Illinois
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I have a question, I am coding 90960 for ESRD 90960 via telehealth and my submissions keep getting denied. I have resubmitted with modifier 96 an then again with GT.
What am I doing wrong and how do I get my claims submitted and paid.
Thank you in advance,
 
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