# modifier 50-debridement performed



## coder1 (Dec 27, 2010)

Good morning coding world.

Can modifier 50 be used for a debridement performed on RT or LT heel 

Eg:

11043     707.07 707.25
11043 50 707.07 707.25

Thank you for your response


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## Lisa Bledsoe (Dec 27, 2010)

Because wounds are not always right vs left, you should use modifier -59 for the separate site.


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## mitchellde (Dec 27, 2010)

Lisa is correct, these are skin debridments and skin is one organ without laterality so you use a 50 modifier to indicate a separate site of the same organ.


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## coder1 (Dec 27, 2010)

Thank you for your quick response...

The scenerio I have is

The doctor see the patient with two pressure ulcers on the buttock. He document one on the Rt side and one on the Lt side. Both ulcers were debrided to Muscle with staging of 4

11043      707.05 707.24
11043 59 707.05 707.24 (the second procedure is being denied by mcr as duplicate)

I'm trying to understand why they would deny with the 59 modifier???


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## mitchellde (Dec 27, 2010)

It is probably due to your ICD-9 being the same for both codes, so you will need to appeal this with the documentation.  Also after January 1 you will only be able to report his code once for each 20 sq cm.


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## pkidd (Dec 27, 2010)

*Debridements*

Agree with above.
However....  Ingenix reports that modifiers RT and LT are acceptable modifiers for CPT 11043.   That might be an option..  
Good luck, pat


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## coder1 (Dec 27, 2010)

Thanks everyone,


There are guidelines for 2011 on how to list pressure ulcer DX.

if its the same site location but different stages they are to be repeated

eg:
11043 707.05 707.23
          707.05 707.24

In the case that everything is the same you will code 707.05 707.23 once.

I appreciate the guidelines for pressure but what if its mutiple wounds  (non pressure)
that are debrided to the same depth ???

for example for this visit there was 5 debridements (open wounds, pressure wound)

eg:
11043 707.05 707.23
          707.05 707.23
          877.1 (same location as ulcer its on the buttock)
          440.23
          707.07 707.23


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## coder1 (Dec 27, 2010)

Pat,

Athena is putting our claims on hold when we use rt and lt.


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## mitchellde (Dec 27, 2010)

coder1 said:


> Thanks everyone,
> 
> 
> There are guidelines for 2011 on how to list pressure ulcer DX.
> ...



Check the guidelines again, if more than one ulcer of the same site but different stages you will have one site code but different stage codes, if you have same site and smae stages then you list each code only once. you do not list the same ICD-9 code more than once, you may link it more than once.


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## coder1 (Dec 28, 2010)

Thank you so much, I looked the guidelines over your correct. I didn't view it myself and wanted feedback because it didn't make sense to me. Thanks again!!!


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