ED Coding and Reimbursement Alert

Question: A patient came to the ED with infected decubiti on two sites that required debridement. Can I bill each site separately, and which codes should I report for this service?


Idaho Subscriber

Answer: You should report 11000 (Debridement of extensive eczematous or infected skin; up to 10% of body surface). You cannot code the sites separately because 11000's descriptor specifies a certain percentage of body surface.

In this case, you should add the total surface area of the two sites together to get the appropriate percentage. Based on that total area, you can report code +11001 (... each additional 10% of the body surface [list separately in addition to code for primary procedure]) if the physician debrides a total area greater than 10 percent.

Remember: Code 11001 is an add-on code, and you can only report it with 11000. If the infected decubiti extend deeper than just the skin, or if debridement involves more than just the skin, you might report a code from the 11040-11044 series (Debridement; skin, partial/full thickness, subcutaneous tissue, muscle and bone).

Reader Questions and You Be The Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, vice president of MRSI in Stoneham, Mass.