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unbundling i&d with debridement

  1. Default unbundling i&d with debridement
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    Our physician saw a pt with a perianal abscess
    Opnote states:
    The area was aspirated percutaneously. An incision was made and the abscess cavity was entered. Pus was evacuated. The loculations were broken up and the overlying skin was debrided to healthy tissue.

    With this information, we billed an I&D only- no debridement (bundled).
    Our physician is questioning why this would not be unbundled with a 59 modifier. I say there is not enough info to verify the unbundling. It is the same anatomical site and there was no separate incision made. Am I correct or should I unbundle and refile?

  2. #2
    i usually use 10061 for complicated i & d whenever there is debridement involved, because your right you should not code them seperately

  3. Default
    We billed the I&D as 46050 since it was perianal. Do you think this may make a difference?

  4. Default
    Any more thoughts on this one? The CCI edits on the EncoderPro say that 46050 can be billed with 11041. I would just like to hear some other opinions before I send this in. With the info I gave in my first post, I don't think there is enough there to bill the debridement.

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