Removal of fixation device with debridement


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I am getting and edit when coding 11043 (excisional debridement) with 20694. Message reads "You have coded 20694 with additional code(s) considered a component of this procedure." NCCI edits consider this separate reporting of codes that are components of the comprehensive procedure if billed for services provided to the same beneficiary by the same physician on the same day. These codes will be rebundled by your payer and payment will be based on code 20694 only." However, I believe the debridement took more time then the removal of the fixation device?

Diagnosis: Status post Charcot reconstruction with external fixation, Wound of right foot

Procedure performed: Right foot: #1 removal of external fixation #2 debridement of wound 2x3 (same foot) consisting of excisional debridement of skin, subtenons tissues portion of the fascia. #3) application of a well-padded short leg splint

The external fixator was removed in total. 2 half pins were removed as well as a trans-calcaneal pin and multiple smooth wires.

Extremity was then prepped, draped, and usual aseptic sterile manner. Patient has edema and venous insufficiency noted to the leg with verrucous hyperplasia nonhealing wound noted at approximate 2 x 3 cm. This was debrided consisted of excisional debridement of skin subtenons tissues portion of the fascia. Remenant of retained suture was removed. Then further debrided utilizing a curette. No purulence no clinical signs of infection were noted. At this time we pulse lavaged the wound out with 3 L normal saline. Please Xeroform over the wound followed by dry dressings and placed the patient in a well-padded posterior splint

Any help would be great! :)


True Blue
Local Chapter Officer
Salt Lake City, UT
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Are these procedures related?

After removal of the device, the holes might need a bit of debridement which would be bundled.

2 X 3 cm area sounds like a different issue to me.

It sounds like the wound that is being debrided is separate than the wounds from the device. If so, they are billable with a modifier. If your not sure, ask your provider before billing.
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