Kelly Posted Wed 26th of September, 2012 20:05:39 PM
I need help coding this procedure:
Partial amputation of the left great toe with the medial aspect of the distal great toe gone. The nail plate was split down the middle and the medial aspect of the nail plate is gone. There is some bone projecting from the wound and there is a flap laceration. Multiple small pieces of dirt and grass were removed with forceps. The toe was anesthetized using a digital block. The flap laceration was repaired with sutures and ther was some debridement of piecies of nail and tissue. The x-ray also showed a tuft fracture.
I didn't think the docomentation supported using cpt 14040 for flap laceration repair.
SuperCoder Answered Thu 27th of September, 2012 16:19:23 PM
You should not report an amputation code for this procedure. Most of the amputation occurred before the patient arrived at the hospital, and the physician just cleaned up the amputation. This scenario calls for a code for debridement and simple closure instead.
Report the debridement as 11044 (Debridement, bone [includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed]; first 20 sq cm or less) because the physician debrided not only the skin but also the muscle and bone.
FYI: In a separate situation, if you needed to report a toe amputation procedure, you would use 11752 (Excision of nail and nail matrix, partial or complete [e.g., ingrown or deformed nail] for permanent removal; with amputation of tuft of distal phalanx).
CPT directs you here because the 28800-28825 codes for amputation involve the whole foot or a larger section of the toe. Also note that 11752 bundles the closure, unlike the debridement code.