Paula Posted Thu 14th of December, 2017 10:55:37 AM
I am new to podiatry coding and find wound care coding very confusing. I have a case (done in the hospital on an inpatient) The patient has a diabetic heel wound 3.5 cm x 1 cm down to the bone. The doctor took the patient to surgery and performed a "Right heel debridement down to the bone, took bone samples for biopsy using a curette and sent the samples to pathology. Then a skin graft jacket was applied to the whole wound down all the way and stapled. The wound was covered with bacitracin, 4x4, kerlix, and Coban.
The bone biopsy confirmed Osteomyelitis.
Can you please advise on how this should be coded. I'm very confused about coding 11044 for the debridement down to the bone: or using 15271-15278 codes for the graft jacket application. Thank you for your help.
SuperCoder Answered Fri 15th of December, 2017 05:03:40 AM
Thanks for your question. Please find below, the answer to your query.
For debridement of heel down to the bone, code 11044 is perfect and for application of a skin graft jacket, you may choose your code from 15271-15278 series.
There is CCI edit between these 2 codes. So, you cannot report both codes together if both procedures are performed on the same anatomical site during same session.
Please feel free to write if you have any questions.
Paula Posted Fri 15th of December, 2017 08:57:14 AM
Thank you for your response; can you tell me why CCI says 11044 is included in 15275?
The debridement was down to the bone including taking bone biopsy samples. The RVU for 11044 is 8.27 and the RVU for 15275 is only 3.96.
I don't understand why they bundled the higher code into the lower code. CCI says if they are reported together only the lower code would be paid.
Shouldn't it be the other way around? The lower RVU procedure should be bundled into the higher RVU procedure?
Paula Posted Fri 15th of December, 2017 09:51:12 AM
If I bill 15275 can I bill the Prep area also since it was a deep debridement with sharp surgical instrument?
SuperCoder Answered Mon 18th of December, 2017 00:56:57 AM
If physician performed preparation of the wound and documentation supports this, then both codes can be billed since there is no CCI edti between these 2 codes.