ICD 10

[fcctn-2008@yahoo.com]

please advice , what is the correct CPT code for excision of NON-PRESSURE CHRONIC ULCER OF SKIN OF SITES W UNSP SEVERITY, I billed the CPT code 11423 to Medicare was denied for 'medical necessity'

 

[thomas7331]

Excisions are not the usual treatment for an ulcer, which is likely why Medicare has denied this. But in order to validate your coding or advise on a CPT or diagnosis code, we'd to see the operative report for the procedure.

 

[kathleeng]

Ulcer DX codes aren't on the 11423 LCD for Medicare. I would look into 11042-11047 as they include removal of chronic ulcers. I'm not sure if it exactly fits your circumstance but it's worth researching into. Excision of pressure ulcers is 15920-15999.