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Thread: How would you code this..... Diabetic Ulcer Debridement

  1. #1
    Join Date
    Apr 2007
    Location
    Albuquerque,NM
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    59

    Question How would you code this..... Diabetic Ulcer Debridement

    I am having some issuse with codeing this I have looked at evrything in the case studie and can not figure it out I get it wrong every time....I need the CPT and ICD 9 Codes for this .Debridement of 16 sq. cm. subcutaneous tissue and muscle due to diabetic foot ulcer. I have 11042 and diagnosis of 249.80 and 707.15 Can some one help please

  2. #2
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    Default

    Hi, just wondering if perhaps your choice of CPT code might be reconsidered, since your note states it involves BOTH tissue and muscle and the 11042 denotes subcutaneous tissue. Dig a little deeper into the code classification. Hopefully, others will comment and set us both straight?
    Suzanne E. Byrum CPC
    Noridian
    NGS

  3. #3
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    Tacoma, WA
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    Default

    If it were me, I would probably code 11043 since muscle is mentioned with a dx of 707.14 primary and 250.00 secondary.
    Last edited by espressoguy; 05-05-2012 at 07:51 PM.
    L. Mark Kozu, COC, CPC, CCC

  4. #4
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    Apr 2007
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    Phoenix, AZ
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    Use 250.8x as the DM code. Read both your ulcer and 250.8x additional code instructions.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  5. #5
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    Default After re-reading the initial post

    Glad there have been some additional responses. I noticed that the poster had listed 249.80 as the diabetes code. Again, you might want to re-examine your choices as thie is the category for secondary diabetes mellitus. Just a thought...
    Suzanne E. Byrum CPC
    Noridian
    NGS

  6. #6
    Join Date
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    Columbia, MO
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    [QUOTE=lopezk89;218971]I am having some issuse with codeing this I have looked at evrything in the case studie and can not figure it out I get it wrong every time....I need the CPT and ICD 9 Codes for this .Debridement of 16 sq. cm. subcutaneous tissue and muscle due to diabetic foot ulcer. I have 11042 and diagnosis of 249.80 and 707.15 Can some one help please[/QUO
    249.x is for secondary diabetes. From ehat you have provided there is nothing to indicate secondary diabetes. Therefore you must code the 250.80
    As the first listed code with the 707.1x secondary.
    To the poster suggesting the 707.15 first with 250.00 secondary:
    When documentation ststes the ulcer is diabetic or due to or eith the disbetes then the diabetes codeust be first listed wit a 4 th digit other than 0 for the complication. I would need a procedure note for the CPT code.
    Last edited by mitchellde; 05-07-2012 at 10:53 AM.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Join Date
    Apr 2007
    Location
    Albuquerque,NM
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    59

    Talking Thank You Everyone

    I have Figured it out with your help ... That little bit info was what was given to me to code from that's why I think I was having some much trouble and the 11042 and the 707.15 and 250.80 where the codes that I needed thank you again ....

  8. #8
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    Apr 2007
    Location
    Springfield, Mo
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    Default

    Medicare, however, wants the DM with manifestation codes listed the other way round. 250.80 first, followed by 707.1X.
    solocoder CPC

  9. #9
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    That is not just Medicare. The diabetes with manifestation code is always first listed according to the coding guidelines.

    Debra A. Mitchell, MSPH, CPC-H

  10. #10

    Default Medicaid Analyst

    The diabetes is coded first. The ICD-9 index under "ulcer, diabetes, foot" indicates to use 250.8x and "ulcer, foot" to use 707.15. Since the submitted information does not indicate the type of diabetes or if it's controlled or not, use 250.80 (type II or unspecified, not stated as uncontrolled) as the primary diagnosis. If the chart note indicates a specific part of the foot, use the most appropriate code in the 707.1x series.

    This is what I would code: 11043 with 250.80, 707.15
    ________________________________
    Isabel Bickle, RN, BSN, CPC
    Medical Policy Analyst
    Division of Medical Assistance Programs
    Salem OR

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