coding debridement with skin graftcoding debridement with skin graft

twZ5C2ayV`C~1S6#9mOk)d4sr$#yd:W8 Eu1EgZ \ 0 E endstream endobj 49 0 obj <>stream Not exactly. Therefore, the more accurate code is a surgical preparation code (15002 15005) for excision (note the term is not debridement) of the open wound to prepare a viable wound surface for grafting. descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work 465 Wound Debridement and Skin Graft Except Hand, for Musculo-Connective Tissue Disorders without CC/MCC 573 Skin Graft for Skin Ulcer or Cellulitis with MCC Any other conditions that may significantly affect wound healing should also be appropriately addressed in the medical record. cm and then debridement codes (with an appropriate modifier) for the remaining 65 sq. o Similar code pairs based on area: 15275 and +15276; 15277 and +15278 CPT Procedure Codes. pls help me whether to code manually debrided ones. 0000008118 00000 n 1 0000020105 00000 n There are multiple ways to create a PDF of a document that you are currently viewing. Revenue Codes are equally subject to this coverage determination. The second code in each set (+15003 and +15005) are add-on codes that you should report for defect area beyond the initial size (for each additional 100 sq cm or 1 percent of body area or part thereof). You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, Supportive Documentation Requirements (required at least every 10 visits) for 97597 and 97598: Medical records must be made available to Medicare upon request. The AMA is a third party beneficiary to this Agreement. v. The depth of the debridement (e.g., to skin, fascia, subcutaneous tissue, muscle, or bone). qe<>O &j'>-3c\BMAi`/@SPPkS u6X \[bkjqkXdV41+ahqg& _p,d4ueQ@Ha s0O Frequent skilled observation and assessment of wound healing are recommended daily or weekly to justify the skilled service. The patient's medical record must contain documentation that fully supports the medical necessity for services included withinthe related LCD. These codes are primarily used when irrigation and . ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS, DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), Some older versions have been archived. Complete absence of all Revenue Codes indicates Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, If the documentation supports that 20 sq. 5. What are the 2020 CPT code changes? If your session expires, you will lose all items in your basket and any active searches. I performed a simple debridement with a full thickness graft of the trunk and reported 15200 and coded also for the debridement, but my coder told me I could not report the debridement. Answer: cm). Surgical Preps: When Do You Code Them? - AAPC Knowledge Center Would also adding Mod 22 help, and for which one 11042 or 11043? Answer: CMS has defined "not usually self-administered" according to how the Medicare population as a whole uses the drug, not how an individual patient or physician may choose to use a particular drug. You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees and agents. Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with Please do not use this feature to contact CMS. cm. 0000000016 00000 n Bilateral Carpal Tunnel Procedures Different Days. As you can see, procedure code 86.69 (other skin graft to other sites) includes the debridement and closure of the amputation site via split-thickness skin graft. 4 Quick Tips for Debridement Coding - AAPC Knowledge Center Prior treatment by a physician, non-physician practitioner, nurse and/or therapist, Description of wound: length, width, depth, grid drawing and/or photographs, Amount, frequency, color, odor, type of exudate, Evidence of infection, undermining, or tunneling, Comorbidities (e.g., diabetes mellitus, peripheral vascular disease), Skilled plan of treatment, including specific frequency, modalities and procedures, Type of debridement performed, including instrument used, to support the debridement code billed, Changing plan of treatment based on clinical judgment of the patients response or lack of response to treatment. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816. Also, you can decide how often you want to get updates. x-ray), and treatment of any infection by antibiotics. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. Article - Billing and Coding: Application of Skin Substitute Grafts for Peruse CPTs Skin Replacement Surgery section, and youll see that the guidelines mention different types of skin grafts. In the presence of documented significant ischemic disease with necrotic ulceration, extensive and definitive debridement may be required. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. cm or less). 0000002591 00000 n When performing debridement of a single wound, report depth using the deepest level of tissue removed. 15271-15278 is the new CPT code series for skin substitute grafts. The appearance and size of the wound (e.g., down to fresh bleeding tissue, 7 cm x 10 cm, etc.) Otherwise, the graft code would have an includes note indicating the debridement is inherent in the code. The AMA does not directly or indirectly practice medicine or dispense medical services. He is an alumnus of York College of Pennsylvania and Clemson University. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. If infection has developed, the patient's response to this infection should be described. Tip 1: Capture Site Preparation 11012 skin, subcutaneous tissue, muscle fascia, muscle and bone. CPT codes 97597 and 97598 are categorized by CMS as sometimes therapy services. 25 0 obj <> endobj CPT code 15002/15005 are only appropriately used in place of service inpatient hospital, . The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. HWAnl))1p9CK,q@:(#"ET.OSnt$v\^lt6btT 9A'w>$bg71w= Y)s.girVu^T_N'%u7Ag>f|vsQ lCN}uCjdgIKLYvO0>E,bRpUuCXX_"RkdEN""/@1] $' O*o5-OEJmq@Hc^VVl 0 Applicable FARS\DFARS Restrictions Apply to Government Use. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. trailer <<1D25FBD66AB6418699B8EC89A49470A5>]/Prev 196840>> startxref 0 %%EOF 74 0 obj <>stream To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom Addition to Skin Graft Codes 15271-15278 is the new CPT code series for skin substitute grafts. Copyright 2023, AAPC That means you should never report 97602 (Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session) in addition to skin graft site preparation codes. Wound debridement is a medical procedure that removes infected, damaged, or dead tissue to promote healing. The surgeon may choose to leave the wound open in anticipation that healthy tissue will grow over the ulcer site. Subsequent debridement is often more superficial and best described by CPT codes 97597 or 97598 rather than 11043 or 11044. Medicare contractors are required to develop and disseminate Articles. Bill types and Revenue codes have been removed from this article. Include dressing: You might find documentation of wound dressing in the op report for skin substitute grafts, but you shouldnt separately code routine dressing supplies for services performed in the office, according to CPT instruction. o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children) 0000030507 00000 n Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. Replacement material, graft size, multiple wounds all these factors and more will come into play when youre coding a skin replacement surgery using skin substitute grafts for conditions such as burns. Biological products that form a sheet scaffolding for skin growth The following procedures are considered part of active wound care management, and are not considered as debridement and are not included in the related LCD: Removal of devitalized tissue from wound(s), non - selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care. Distinguish the codes based on body site, as follows: Each pair of codes identifies the size of the defect created by the surgical preparation, with the first code (15002 or 15004) describing the first 100 sq cm for adults and children aged 10 and up, or 1 percent of body surface area for children under 10 years of age, including infants. 2. 0000002478 00000 n PDF Billing and Coding Guidelines - Centers for Medicare & Medicaid Services Article document IDs begin with the letter "A" (e.g., A12345). I work in an acute care center with a burn unit and have been striving for accuracy and consistency. cm. Autologous skin grafts are those that the surgeon harvests from another healthy part of the patients own body, and you would use different codes for those graft procedures. that coverage is not influenced by Bill Type and the article should be assumed to An operative note or procedure note for the debridement service. Wound Care | CPT Codes for debridement - CodingIntel 0000010293 00000 n Q: I have been trying to determine whether a skin graft includes debridement. When subcutaneous tissue is debrided from a 16 s. cm dehisced abdominal wound and a 10 sq cm thigh wound, report 11042 for the first 20 sq cm and 11045 for the second 6 sq cm. Instead, report 15273 and 15274 for the application of skin grafts of the arm, and codes 15277 and 15278 for application of skin grafts of the hands and fingers. 0000013585 00000 n PDF Billing and Coding Guidelines: Contractor Name - Centers for Medicare *This response is based on the best information available as of 11/16/17. j0 W0 Refer to NCCI and OPPS requirements prior to billing Medicare.For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.The diagnosis code(s) must best describe the patient's condition for which the service was performed. No fee schedules, basic unit, relative values or related listings are included in CPT. endstream endobj startxref GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Coding for skin replacement surgery in 2012 | The Bulletin Question: If you would like to extend your session, you may select the Continue Button. In CPT, coding these grafts by size is a novel concept. There are lessons to be learned to avoid damaging coding habits. PDF Physician Office Billing & Payment Guide - Integra Life When to Code Debridement As a Separate Procedure appropriate codes to use when performing a non-surgical application of a skin substitute. Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. Codify Subscriber Answer: You should [], Copyright 2023. To code the excision, look in the index for the term Lesion, then Skin. When can I report debridement separately? Some articles contain a large number of codes. PDF Billing and Coding Guidelines for Wound Care - Centers for Medicare Add skin substitute: When your surgeon performs a skin substitute graft, the supply of the skin substitute/ graft should be reported separately, according to CPT instruction. You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. |S=LqO=Vz Peruse CPTs Skin Replacement Surgery section, and youll see that the guidelines mention different types of skin grafts. 2022 HCPro, a brand of Simplify Compliance. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. When debridements are performed, the debridement . Follow our experts tips to make sure you select the proper code and get all the pay your surgeon deserves for these services. The Medicare program provides limited benefits for outpatient prescription drugs. Answer: No. This method may require the surgeon to perform "staged" debridements as the wound heals. While every effort has been made to provide accurate and 3. A description of the type(s) of tissue involvement, the severity of tissue destruction, undermining or tunneling, necrosis, infection or evidence of reduced circulation. [ 4"!|F. k The CMS.gov Web site currently does not fully support browsers with Codes 15002-15005 apply specifically to describe the work of "preparing a clean and viable wound surface for placement of an autograft, flap, skin substitute graft or for negative pressure wound therapy," according to CPT guidelines. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. preparation of this material, or the analysis of information provided in the material. cm and documented 20 sq. To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. A description of the tissue removed (e.g., necrotic, devitalized or non-viable) The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered. Coding and Billing for Skin Substitute Grafts Skin substitute graft application code selection is based on defect site location and size. I work in an acute care center with a burn unit and . culture and sensitivity), osteomyelitis (e.g. Replacement material, graft size, multiple wounds all these factors and more [], Dont miss pregnancy impact. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be Terms: Primary intention means that the edges of the wound or graft are closed to allow them to grow together, while secondary intention refers to allowing an open wound to heal from the base up by building new tissue. Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths. MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. The treatment plan for a patient who requires frequent repeated debridement should be reevaluated, to ensure that pressure reduction and infection control have been adequately addressed. Include dressing: You might find documentation of wound dressing in the op report for skin substitute grafts, but you shouldnt separately code routine dressing supplies for services performed in the office, according to CPT instruction. 0000015008 00000 n If the wound is being excised, not just debrided, at the time of split thickness skin graft placement then you could also report a surgical preparation code (e.g., 15002, 15004) in addition to the skin graft code. Terms: Primary intention means that the edges of the wound or graft are closed to allow them to grow together, while secondary intention refers to allowing an open wound to heal from the base up by building new tissue. Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. Like the site preparation codes, CPT distinguishes these codes by anatomic site and wound surface area, as follows: o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm The Current Procedural Terminology guidelines state that debridement is considered a separate procedure "when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure." The patient's comorbid medical and mental condition, and all health factors that may influence the patient's ability to heal tissue, such as, but not limited to the following: mental status, mobility, infection, tissue oxygenation, chronic pressure, arterial insufficiency/small vessel ischemia, venous stasis, edema, type of dressing, chronic illness such as diabetes mellitus, uremia, COPD, malnutrition, CHF, anemia, iron deficiency, and immune deficiency disorders. To bill for an Apligraf (HCPCS Q4101) package (equal to 44-sq. Tip 3: Know Whats Included hb```, cc`a4`` $0oP>+Z5:,PaE$L[R\w0`r`,p{^gnq))&%xBiS*,8yUSc3AOSAk*+L|0$nELLuH0|Rfp1drcH/i*@r? To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Answer: Your coder is correct simple debridement is included in the graft codes. Complete documentation for excisional debridement requires five elements, including: i. Skin replacement surgery consists of two basic steps: surgical preparation of the recipient site and placement of the graft with fixation. complete information, CMS does not guarantee that there are no errors in the information displayed on this web site. Continuation of treatment plan with ongoing evidence of the effectiveness of that plan, including diminishing area and depth of the ulceration, resolution of surrounding erythema and /or wound exudates, decreasing symptomatology, and overall assessment of wound status (such as stable, improved, worsening, etc). application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) All Rights Reserved (or such other date of publication of CPT). Question: If any of these elements is missing, documentation does not meet the criteria for excisional debridement. To participate in the NAHRI forum discussions, you must be a member of the NAHRI community. Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). (application of skin substitute graft to, for example, leg or ankle). This is reported with a single code, 11044. Determining the wound location and surface area is important in order to select the appropriate CPT code. Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. 0000027593 00000 n If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. 8u-0=*.tCOeF8h`TLeHRzLco`@X(d9rFdcG VA,P&l 39 0 obj <>stream 0000016569 00000 n Add together the surface area of multiple . If the surgeon leaves the wound open, you will report a debridement (11040-11044) rather than an excision. This email will be sent from you to the Answer: Not exactly. 7500 Security Boulevard, Baltimore, MD 21244. Size: To determine the surface area for code selection, add all areas within the same anatomic grouping, if the surgeon prepares multiple wounds. 0000004501 00000 n cm involved a skin substitute application, you can report 15271 for the 20 sq. In ICD-10-PCS, the user may elect to look in the Index under Advancement which provides options to see Reposition or see Transfer. Include cleaning: When the surgeon performs a simple cleansing of the wound, that service is included within the skin substitute procedure codes, according to CPT instruction. CPT codes, descriptions and other data only are copyright 2022 American Medical Association. In ICD-9-CM, the Alphabetic Index main term entry is Graft; subterm entry fascia, which directs users to code 83.82, Graft of muscle or fascia. 0000006208 00000 n The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. A determination of the initial treatment plan to include the expected frequency and duration of the skilled treatment and the potential to heal. 15002 and +15003 for trunk, arms, legs (including wrist or ankle) The following products may be billed with CPT codes 15430-15431 . that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. 3]HE1}}&Z\d3aD)6C~NYZgois\t-w;s3N>dgp@GtBisMaq)%le"Z\g.j4 9qEb*NLaQD\/z a\)DC|[JkHHq\J.d&X. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. AHA copyrighted materials including the UB‐04 codes and Draft articles are articles written in support of a Proposed LCD. For example: Bone is debrided from a 4 sq cm heel ulcer and from a 10 sq cm ischial ulcer. Is this right? 1. uKEmc2vy5\^gB:w76>9s=gKn4"=yJ} crv[d[ ML\:6q~6U6_Nc8Dc?nN8^>\RY[qZ{XO*JT!e,(7=m]7}}O@gSS(B"t658>~.%W['i9hch8bQT%ml resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; The page could not be loaded. American Hospital Association ("AHA"), Reader Question: Distinguish Additional Lesion Excision Method, CCI Edits: Navigate Surgery Bundles That Could Compromise Your Pay, ICD-10 Changes: Master Guidelines for Infection, Sepsis. 0000006836 00000 n The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. Q&A: Billing for wound debridement and skin substitute application 11042 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less + 11045 - each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) John Verhovshek, MA, CPC, is a contributing editor at AAPC. Q: The physician documented debridement (11043x1 & 11046x4) of a wound 85.25 sq. This Agreement will terminate upon notice if you violate its terms. cm; we know that many times the actual size of the skin substitute is larger than the area that was covered. Tip 2: Identify Type of Skin Substitute Graft. 0000001292 00000 n In your case, the wound is being closed with a split thickness skin graft so the debridement codes are not accurate in this situation. Grasp measurement rules.
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