• E-mail
• Print
• RSS

Report an E/M level with a debridement code only if the facility provides significant and separately identifiable services from the debridement

APCs Weekly Monitor, August 8, 2008

Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!

QUESTION: I code for a wound care facility and I disagree with my colleagues on when to assign an evaluation and management (E/M) level with a debridement code from the 11040-11044 range. It is my understanding that if the visit is for a debridement, then we should report only the debridement code and not an E/M level charge?unless the visit was also for another reason other than debridement. For example, ?check on blood pressure and new medications prescribed? or ?patient running fever and antibiotic prescribed.? When can we report an E/M level with a debridement code?

ANSWER: As we discussed in last week?s APCs Weekly Monitor Q&A, in order to report an E/M visit with a procedure such as a debridement, the visit service must be significant and separately identifiable. To analyze whether this is the case, start with the procedure that the facility provided. Were there any services that were significant and separately identifiable beyond the usual preoperative and postoperative services provided with the debridement procedure?

In both of the examples described above, the facility provided work that was beyond the usual preoperative and postoperative services performed with the debridement. If fappropriate documentation is present for these services, you should bill them separately as an E/M visit and append modifier -25 to indicate they are significant and separately identifiable from the pre-operative portion of the debridement procedure.

Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!

• Comment
• E-mail to a Colleague
• Print
• RSS
• Archive

Comments