Cindy Posted Mon 29th of April, 2013 15:29:08 PM
Patient is scheduled for an adenotonsillectomy and has a significant nasal abrasion wound from repetitive skin rubbing, '910.0', that would benefit from wound care and layered wound dressing application that is planned while she is under anesthesia. The closest CPT code to describe the procedure that my physicain plans to perform is '97602', which is a code for a non-physician professional. Is there a different CPT code for the physician to use for this additional care? The only CPT code that I could find to match with this diagnosis is '15819' which does not apply to this case.
SuperCoder Answered Tue 30th of April, 2013 14:34:03 PM
Physiatrists Should Use 11040 Series
When physiatrists perform debridement, the code series 11040-11044 should be billed. Not only do these codes reimburse higher than 97601-97602 (see chart below), they can also be billed more than once per session. For instance, if a physiatrist debrides partial-thickness wounds on a patient's left arm and left thigh, she can bill 11040 twice, with modifier -59 (Distinct procedural service) appended to the second site.