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Rosalind Richmond, chief coding and compliance officer of GENASCIS, which provides revenue cycle services and supporting technologies for surgery centers, outlines the 2011 CPT changes made to codes in the integumentary system.
Debridement
Below are key changes, additions and revisions to the Inegumentary System, specific to Debridement:
- Subheading revised, removing reference to excision.
- 11010, 11011, 11012 revised, replacing "associated with open fracture" with "at the site of an open fracture".
- 11040, 11041 deleted, to report use 97597, 97598 for debridement of skin, i.e., epidermis and/or dermis.
- 11042, 11043, 11044 revised by surface area and depth.
- +11045, +11046, +11047 added.
- 97597: Debridement (e.g., high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (e.g., fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less.
- 97598: each additional 20 sq cm, or part thereof. Note: Do not report 11042-11047 in conjunction with 97597-97602.
- Single wound reported to the depth of deepest level.
- Multiple wounds reported by sum of the surface area of wounds of same depth.
- Do not sum wounds of different depths, report codes for appropriate depths with modifier -59 with codes 11042, 11045 and 11044.
Repair (Closure)
Complex repair includes the repair of wounds requiring more than layered closure, viz., scar revision, debridement (e.g., traumatic lacerations or avulsions), extensive undermining, stents or retention sutures. Necessary preparation includes creation of a limited defect for repairs (e.g., excision of a scar requiring a complex repair) or the debridement of complicated lacerations or avulsions. Complex repair does not include excision of benign (11400-11446) or malignant (11600-11646) lesions, excisional preparation of a wound bed (15002-15005) or debridement of an open fracture or open dislocation.
Skin Replacement Surgery and Skin Substitutes
Surgical preparation guidelines have been revised:
- 15002-15005 related to graft placement, flap, skin replacement, skin substitute, or negative pressure wound therapy.
- In some cases closure may be possible using adjacent tissue transfer (14000-14061) or complex repair (13100-13153).
- Appreciable nonviable tissue is removed to treat a burn, traumatic wound or necrotizing infection.
- Intent is to heal wound by primary intention or negative pressure wound therapy. When intent is to heal by secondary intention use debridement codes.
- The closure, application of graft, flap, skin replacement or skin substitute may be delayed, but the intent is to include these treatments.
- Do not report 15340, 15341 in conjunction with 11042, 15002-15005 and 15430, 15431 in conjunction with 11042, 15002-15005.
Learn more about GENASCIS.
The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.
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