# Wide excision of ulcer



## codedog

Anyone now a cpt code for wide excision of a nonheling ulcer from lower extremity, ?


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## Treetoad

Take a look at the description of procedure 12020.  Does it sound anything like what you're doing?


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## codedog

here's the report
  the patient had general anesthesia,  2 cm was marked around the area in a circular fashion. The area was  was removed with  2 cm rim all the way  down to the fascia of the right extremity.  the mass was removed and sent to pathlogy for permanent sectioning. Excellent hemostasis was noted. The area was packed with 4x4 and the wound was dressed with kerlix and then ace bandage.  

dx- was chronic nonhealing right lower etremity ulcer.  
procedure -was  wide excision of area
 pathalogy report - non healing leg  ulcer- dx code 707.9


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## corkey4

W





trent123 said:


> Anyone now a cpt code for wide excision of a nonheling ulcer from lower extremity, ?


 WOULD THIS NOT FALL UNDER DEBRIDEMENTS/11040-11044 DEPENDING OF DEBTH?


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## corkey4

corkey4 said:


> W WOULD THIS NOT FALL UNDER DEBRIDEMENTS/11040-11044 DEPENDING ON HOW DEEP?


XXXXX


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## Anna Weaver

*ulcer*

I too would use the debridement codes, but the physician will have to give more documentation. The size, depth, stage etc., and I would also use the 707.10 instead of the 707.9 as the location is listed as leg.


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## Treetoad

I agree.  This really does sound more like a debridement.


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## mbort

I agree that it sounds like more of a debridement too, however I would be cautious since he did state "wide excision of MASS".  I would get this clarified.  The depth of the debridement is in the note and indicated as "all the way down to the fascia" so you wont need to find out the depth.  The size wont be an issue if this is a debridement as those codes are not size related.


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## mgord

If the note states "all the way down to the fascia" does this support 11043 or 11042?


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## Treetoad

Unless it actually included the fascia, I would stick with subcutaneous tissue.


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## mitchellde

Not be the devil's advocate here but I do not get the impression this was a debridement at all, I would either go to excision of soft tissue mass which codes out as removal of tumor by anatomic sie ot to incision of soft tissue abcess deep.  He did not just remove devitalized tissue he excised the mass which was sent to path and determined it was an ulcer.  Just a thought


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## mgord

What if the physician debrided skin, subQ and tendon? He believes it should at least be a 11043 but he did not remove any muscle tissue.


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## Treetoad

If the tendon was involved in a debridement, then there is justification to go with a muscle debridement code.


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