Teresa Posted Tue 31st of March, 2020 10:51:06 AM
The patient brought from the suite, laid supine on the table and anesthesia was administered through her tracheostomy. The dressing was taken down. There was Q areas of necrotic fascia which were excised. Overall however the wound was clean. The depth was down to the deep fascia. The total area of debridement was less that 20cm. Once all this was accomplished the wound VAC was replaced. There was evidence of wound contraction and granulation and epithelial migration. The back held pressure at negative 125 mmHg. Not sure if I'm using the correct CPT on this one, 11006, any help is appreciated.
SuperCoder Answered Wed 01st of April, 2020 04:27:59 AM
Thanks for your question.
The code range 11004-11006 are used for debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection.
As per the limited documentation, the anatomical area debrided, is not addressed. Kindly check the documentation for the external genitalia, perineum, and abdominal wall. If the necrotic fascia of genitalia, perineum, and abdominal wall is debrided then code 11006 can be used.
Code 11006 suggests that the patient is appropriately prepped and anesthetized, the provider evaluates the extent of the necrotic tissue in the external genitalia, perineum, and abdominal wall. The provider resects and debrides all the infected necrotic skin, subcutaneous tissues, fascia, and muscle by using surgical instruments such as a scalpel, scissors, or other tools. The provider tries to preserve as much viable skin and subcutaneous tissue as possible. The provider, by doing this, allows the remaining healthy tissues to heal properly. The provider then controls bleeding, applies antibiotics, and packs the open wound with saline soaked gauze. The provider may complete the procedure with or without fascial closure in which he closes the fascia of the abdominal wall.
Hope this helps.