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Coding of ulcer debridement

  1. #1
    Default Coding of ulcer debridement
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    I need clarification on how to calculate the debridement of a sacral ulcer. The surgeon did not specify the total amount of debrided tissue, but he did give the before and after wound sizes;

    "Pre debridement measurements of this full-thickness stage IV [sacral] ulcer were 9cm long by 8 cm wide by 4 cm deep. There was foul-smelling necrotic tissue at the superior margin and in the depth of the wound. The inferior margin was actually somewhat clean and with evidence of granulation tissue. That caudal or inferior margin was also only about 15 mm away from the anal verge. This also was then sharply debided with the Bovie such that the ultimate wound measurements were 9 cm long by now 10 cm wide by 7 cm deep. The debridement was into subcutaneous fat as well as musculature of the buttock, as well as exposed periosteum of the sacrum in several areas, but no bony debridement was done nor thought to be required as that periosteum appeared to be healthy..."

    If the surface area of the wound before debridement is 288 square cm (9x8x4), and the surface area after debridement is 630 square cm (9x10x7), then the difference is the amount of tissue debrided , correct? So 630-288= 342 square cm debrided down to the periosteum. I chose code 11044, and 11047x17. Am I doing this right??

    Thanks

  2. #2
    Default rethinking calculation
    Actually, I'm rethinking the depth portion of the calculation. The original depth does not matter; it's the difference between the beginning and ending depths that are used to calculate...so

    9x8= 72 original surface area of wound
    9x10= 90 ending surface area x 3 cm of increased depth= 270
    270 - 72 = 198 total square cm debrided

    So that would be codes 11044, and 11047x9.
    Can anyone confirm?

    Thanks again

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