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Excisional debridement of incisional necrosis

  1. #1
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    Default Excisional debridement of incisional necrosis
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    Can somebody help me? (new coder here!)

    Pt came to Minor Surgery with Incision necrosis, left TMA. (transmetarsal amputation) Procedure performed is excisional debridement using scalpel and versajet of left TMA site.

    1. Do I code it as a complication of the TMA surgery 997.69?

    2. Scalpel was used to remove eschar, which revealed fibrous tissue. This was debrided w/Versajet to stimulate bleeding tissue. Is this actually an excisional debridement?

    I've been playing around with this for a while and have finally given up!

    Any advice is gratefully appreciated!

  2. #2
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    An excisional debridement changes the margins of the wound. Pre- and post-debridement measurements are different. If the wound margins don't change because only fibrinous slough or necrotic tissue is removed, code for active wound care management 97597-97598.
    The diagnosis seems reasonable, although I would also check for underlying conditions that may affect healing (e.g. diabetes, PAD, etc.).

    Jen

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