Wiki Mod 25 Wound Care

[lbullock1]

I'm looking for guidance on if it is appropriate to bill an E/M in addition to a debridement if the provider suspects an infection in the wound? The patient comes in for their weekly debridement appointment, the provider performs a 11042 debridement, takes a wound culture and prescribes an antibiotic. Does the wound culture and antibiotic prescription meet the guidelines for billing a separate E/M?

 

[manny23]

Hi,

Reason for encounter is debridement service as complication of same problem/wound addressed, doesn't constitute a separate E/M here as per the above scenario.

Thanks,
Manny
(Medicare institutional billing RTP specialist & investigator, CMS A/B expert, FI proficient, CPC)

 

[melissaknight82@yahoo.com]

I agree with Manny it would have to be a new wound or another problem like an infection elsewhere to be separately identifiable.