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15935-52 vs 11044

  1. #1
    Smile 15935-52 vs 11044
    Medical Coding Books
    When a sacral decubitus ulcer is debrided in the OR- including ostectomy- WITHOUT a closure: We have been advised (by a consultant) we can not report 15935 (because it includes a surgical closure). How about 15935-52?? 20999 was given to us by the consultant in this scenario- Any advice on what to report?
    I am uncomfortable with using the unlisted code.
    Our FI LCD states to use the 11010-11044 for surgical debridements of a decub., but the consultant advised us only to use these CPT codes for wound care clinic.
    LCD states: The documentation for these procedures should include the indications for the procedure, the type of anesthesia if and when used, and the narrative of the procedure that describes the wounds and the details of the debridement procedure itself. The debridement code submitted should reflect the type of tissue removed during the procedure and not the depth, size, or other characteristics of the wound. For example, if a wound involves exposed bone but the debridement procedure did not remove bone, CPT code 11044 cannot be billed.
    Last edited by dk; 10-29-2009 at 06:03 AM.

  2. #2
    I feel you can use 15935 with 52 showing that the wound was not closed.

  3. Default
    I was looking for this today and felt this article was a good source of info:

  4. #4
    Thank you for all the information. I was needing the same info

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