# Debridement & Excision Coding Help



## RainyDaze (May 3, 2010)

Hi All,

I need help with the procedure.  I'm thinking 11042 is all I'll be able to code.  The op report is here:

Diagnosis:  Necrotizing fasciitis of the right lower extremity

Procedure:  Right lower extermity debridement and excision of devitalized tissue with pulsavac irrigation.

Description of procedure:  the patient was laid in supine posiiton after adequate general endotracheal anesthesia.  Her right lower extremity and abdomen were sterilely prepped and draped in the normal fashion.  Upon examination in the operating room, the patient ahd no obsious involvement of perineum.  There was significant induration of the right medial aspect of the thigh with a punctate lesion in the middle.  The induration extended up towards the right inguinal crease.  An incision was made over this area down through the subcutaneous fat, which was not bleeding, and had watery discharge consistent with necrotizing fasciitis.  All devitalized tissue was excised.  A portion of the excised tissue was sent for would culture as well as culture swabs taken.  The subcutaneous fate and skin were taken down to the adductor muscles which were bleeding and contracting witht he bovie cautery and appeared to be viable.  The wound was debrided back to bleeding fat as well as healthy tissue.  This was extended up towards the inguinal crease.  The femoral vessels were protected with the adductor muscles which appeared viable.  The proximal portion of the would was again viable.  This was not extened up above the inguinal ligament.  The wound was then pulsavaced with several liters of slaine, and we kerlix gauze was applied to the wound.


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## RainyDaze (May 4, 2010)

I did, but this was performed on the thigh so I thought those codes wouldn't be appropriate??


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## Kimmers (May 11, 2010)

That is a poser for sure!  11042 is the best code for debridement; skin and subcutaneous tissue. I would use 11042. My only other thought was to go with a lesser code and code 11000 and add 11001 depending on the total body surface area affected. 




RainyDaze said:


> Hi All,
> 
> I need help with the procedure.  I'm thinking 11042 is all I'll be able to code.  The op report is here:
> 
> ...


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## jodierellis (May 11, 2010)

I agree with your 11042.


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