# Scrotal Debridement



## KaylaRieken (Feb 18, 2021)

On the inferior aspect of the scrotum and midline, there was roughly a 4.5 x 3 cm area of necrotic skin tissue. I debrided this at bedside today after the patient received some pain medication. It appears to be 2 separate pockets that I suspect had abscess fluid in them, spontaneously decompressed. The dependent portion fo the necrosis makes it possible that the patient may have had some padding or some other device in his diaper because of the appearance of the ischemic necrosis. There is no palpable crepitus. The wound defects were packed with Dakin soaked gauze. 

We coded this as 11043 (after talking to the provider) with diagnosis code N49.2 for scrotal cellulitis. It got denied for medical necessity. Is there a different diagnosis that I could use for this code?


----------



## liqgold2@aol.com (Feb 22, 2021)

The 11042 and 11043 codes are used most often for orthopedic debridements and may not include the genitalia. Your case sounds more like a Fournier's gangrene, N49.3, and associated scrotal necrosis. Consider CPT code 11004. Your CPT code and ICD-10 diagnosis would seem inappropriate in this case.
Michael A. Ferragamo MD, FACS


----------

