Results 1 to 7 of 7

Coccygectomy with excision of sacral pressure ulcer?

  1. Default Coccygectomy with excision of sacral pressure ulcer?
    Medical Coding Books
    I have a scenario with a coccygectomy and excision of sacral pressure ulcer it is stated that they area was packed with a damp dressing rather than sutured.

    I have a group class mate that is wanting to use 27080 and 15933 . I do not think you can do this for a few reasons:

    1. it states with primary suture, however the procedure description states that it was packed with a damp dressing and mentions nothing of using sutures.
    2. The code 27080 is for the excision of the coccyx, so it would not be necessary to use another code describing bone removal (ostectomy)


    Could these codes be used for this? If not, would only 27080 cover the excision of the coccyx as well as the excision of the sacral pressure ulcer?

    Thanks

  2. #2
    Post
    Please check this set of codes: 27080, 15931-52. Mod 52 is placed for reduced service of not repairing the wound with sutures and leaving it to heal by secondary intention.
    Girish Dadhich, CPC

  3. #3
    Default
    Quote Originally Posted by sweetybird0472 View Post
    I have a scenario with a coccygectomy and excision of sacral pressure ulcer it is stated that they area was packed with a damp dressing rather than sutured.

    I have a group class mate that is wanting to use 27080 and 15933 . I do not think you can do this for a few reasons:

    1. it states with primary suture, however the procedure description states that it was packed with a damp dressing and mentions nothing of using sutures.
    2. The code 27080 is for the excision of the coccyx, so it would not be necessary to use another code describing bone removal (ostectomy)


    Could these codes be used for this? If not, would only 27080 cover the excision of the coccyx as well as the excision of the sacral pressure ulcer?

    Thanks
    I would think that the ostectomy 15933-52 (not sutured) is included and I personally would not use 27080... The 15933 is for excision and removal of the bone. Per coding companion. I would use 15933-52
    CRC CPC

  4. Default
    Anatomically, sacral segments are different entity from coccyx though thEY are all fused together as one piece.
    So, you have to report them separately.
    27080- for coccygectomy.
    15931 for excision sacral pressure ulcer, 15933 for excision of the pressure ulcer plus excision of the sacral bony tissues involved in the pressure ulcer.
    If you go into the pathophysiology of pressure ulcers, there are 4 STAGES OF PRESSURE ULCERS CLASSIFIED:

    STAGE III - INVOVLES FULL THICKNESS LOSS OF THE SKIN BUT NOT THROUGH THE FASCIA.
    STAGE IV - THE ABOVE PLUS COULD INVOLVE FASCIA , AND THE UNDERLYING BONE, CAUSING EXTENSIVE DESTRUCTION AND NECROSIS, REQUIRING DEEP SURGICAL DEBRIDMENT , NECESSITATING REMOVAL OF SOME OR MORE PARTS OF THE OSTEUM(BONE TISSUE ) ie, OSTECTOMY OF THAT PARTICULAR PART OR SEGMENT OF THE INVOLVED BONYTISSUE.

    What I am trying to say is : the "Coccygectomy" 27080 does not bundle the excision of the pressure ulcer(15931), nor the excision of pressure ulcer with "ostectomy"15931. So this ostectomy is not the same as coccegectomy.

  5. Default
    Quote Originally Posted by preserene View Post
    Anatomically, sacral segments are different entity from coccyx though thEY are all fused together as one piece.
    So, you have to report them separately.
    27080- for coccygectomy.
    15931 for excision sacral pressure ulcer, 15933 for excision of the pressure ulcer plus excision of the sacral bony tissues involved in the pressure ulcer.
    If you go into the pathophysiology of pressure ulcers, there are 4 STAGES OF PRESSURE ULCERS CLASSIFIED:

    STAGE III - INVOVLES FULL THICKNESS LOSS OF THE SKIN BUT NOT THROUGH THE FASCIA.
    STAGE IV - THE ABOVE PLUS COULD INVOLVE FASCIA , AND THE UNDERLYING BONE, CAUSING EXTENSIVE DESTRUCTION AND NECROSIS, REQUIRING DEEP SURGICAL DEBRIDMENT , NECESSITATING REMOVAL OF SOME OR MORE PARTS OF THE OSTEUM(BONE TISSUE ) ie, OSTECTOMY OF THAT PARTICULAR PART OR SEGMENT OF THE INVOLVED BONYTISSUE.

    What I am trying to say is : the "Coccygectomy" 27080 does not bundle the excision of the pressure ulcer(15931), nor the excision of pressure ulcer with "ostectomy"15931. So this ostectomy is not the same as coccegectomy.
    Preserene,

    Thank you. This is how my coding instructor explained this to me as well, however for the scenario we were presented with it did not state what stage the ulcer was at. I used the unspecified code and it was correct. Here is the actual procedure note.

    PREOPERATIVE DX:Sacral pressure ulcer, osteomyelitis of the coccyx.

    POSTOPERATIVE DX:Sacral pressure ulcer, osteomyelitis of the coccyx.

    NAME OF PROCEDURE:Coccygectomy, debridement and irrigation of sacrum, with sacral bone biopsy, excision of pressure ulcer.

    ANESTHESIA:General

    PROCEDURE DESCRIPTION:Anesthesia was administered and the patient was then prepped and draped. The sacral pressure ulcer was excised widely. The coccyx was then removed. Half was sent to Pathology and half was sent to the Lab for culture. The sacrum was then debrided & a Bx obtained. Again, half was sent to Lab for culture and half was sent for eval of osteomyelitis. The wound was then irrigated with a pulse lavage using antibiotic solution. The area was packed w/ a damp dressing.

  6. Default
    Debridement of the Sacrum itself means it is stage 4 (bone debridement) and excision is done .So the CPTcode to be reported 15933. ie with ostectomy.

    [please correct my typing mistake of 15931for with ostectomy. I should have typed it as 15933].
    Even if the stage was not written by your doctor , in the operation report it is clear that there was bone involvement and debridement of bone is done.

    So your case merits for 15933 and not 15931, along with 27080

  7. Default
    Thank you so much!

Similar Threads

  1. Replies: 1
    Last Post: 11-02-2015, 01:37 PM
  2. Sacral ulcer and osteomyelitis
    By Om in forum Diagnosis Coding
    Replies: 1
    Last Post: 02-16-2015, 05:12 AM
  3. bleeding from sacral decubitus ulcer
    By ggparker14 in forum Diagnosis Coding
    Replies: 1
    Last Post: 10-12-2012, 08:02 PM
  4. Pressure ulcer & diabetic ulcer
    By dvanhaneghan in forum Diagnosis Coding
    Replies: 0
    Last Post: 07-18-2012, 10:29 AM
  5. Excision distal coccygectomy and perineal cystic mass
    By marycpc in forum General Surgery
    Replies: 2
    Last Post: 04-12-2012, 09:29 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.