multiple ulcers of same site

foguingt

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Hi

I'm new to coding wound debridements and I have a couple of questions.
If a patient has two ulcers on the right foot of different depths would I use one code or two?

For example:eek:ne code was debrided of the subcutaneous tissue 20 cm.
The second wound on the same foot was debrided of the muscle 20 cm.

Would I use 11042 and 11043 or just 11043


Also, for wound debridements (11042-11047; 97597 & 97598) what would typically be included in the Evaluation and Management codes?

Also, what are some good wound care resources?
 
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BUDDY1983

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Multiple Ulcer same site

If the debridement is for the same wound muscle and subcutaneous the 11042 is bundled in to 11043. See CCI edits you would only bill the 11043. If you have two ulcers dribrided subcutaneous left leg and muscl right leg than you can append the modifier 59 and bill both.

Hope this helps!:)


For resources I would get the NHIC LCD on debridements and look in the Physicial therapy LCD for 97597-97605 wound procedures.
 
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foguingt

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Multiple ulcers same site

The ulcers are on the same site (foot) However they are on two different locations of the foot. Say, one is on the top of the foot (subcutaneous, code 11042) and one is on the bottom of the foot (muscle code 11043) Would I code just 11043 or 11042 and 11043? Thanks for the resources any help I can get, it would be greatly appreciated!
 

armen

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The ulcers are on the same site (foot) However they are on two different locations of the foot. Say, one is on the top of the foot (subcutaneous, code 11042) and one is on the bottom of the foot (muscle code 11043) Would I code just 11043 or 11042 and 11043? Thanks for the resources any help I can get, it would be greatly appreciated!
I would code both. 11042-59 and 11043. The fact that it is tha same foot does not mean it is the same location. For example, it can be 11042 for medial ulcer of RT foot and 11043 for lateral ulcer of the same foot. Just make sure you put a note in box 19 of HCFA form for each code (ex. 11042-medial; 11043-lateral) to specify the location. It may be denied, so if I would be you, I would submit it on paper with notes attached.
 
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