Health Information Management

Tip: Correctly code excisional debridement

APCs Insider, September 21, 2012

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Excisional debridement is the sharp removal of tissue at the wound margin or at the wound base until viable tissue is removed. Coders report excisional debridement codes (CPT codes 11042-11047) based on the deepest layer of viable tissue removed.

The codes for excisional debridement are divided by the level of tissue removed and the size of the wound debrided. If the physician removes only subcutaneous tissue, coders would report CPT code 11042 for the first 20 sq cm and 11045 for each additional 20 sq cm. So if the physician documents removal of 65 sq cm of subcutaneous tissue, coders would report 11042 and 11045x3.
 
For debridement of muscle or fascia, coders report 11043 for the first 20 sq cm and 11046 for every additional 20 sq cm. If the physician debrides a wound down to the bone, report 11044 for the first 20 sq cm and 11047 for each additional 20 sq cm. Note that the add-on codes for additional sq cm do not directly follow the codes for the first 20 sq cm.

 

The tip is adapted from “Differentiate between types of wound debridement” in the July Briefings on APCs.



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