General Surgery Coding Alert

Pressure Ulcer: 1104X or 159XX: 4 Tips Focus Decubitus Ulcer Code Selection


- Published on Thu, Apr 12, 2012

Don't miss CPT® 2012 debridement equation.

With over 25 CPT® codes and nine ICD-9 codes to describe your surgeon's pressure-ulcer patient encounter, you could use a few hints to make sure you capture all the pay you deserve. Follow our four expert guidelines to make sure you choose the right codes -- every time.

1. Distinguish Excision vs. Debridement

Although CPT® provides 20 "pressure ulcer" codes (15920-15999), those aren't your only choices when your surgeon treats a decubitus ulcer.

The first bit of information you'll need to extract from your surgeon's op note is: Did she excise the ulcer and close the wound, or did she debride the ulcer and allow the wound to stay open to heal? The answer to that question will lead you to choose codes from one of the following groups:

  • 15920-15999 -- Excision ... pressure ulcer ...
  • 11042-+11047 -- Debridement ...

According to CPT® instruction, you may report [...]

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