ED Coding and Reimbursement Alert

Reader Questions:

Do This When Counting BSA for Debridement

Question: If the ED physician debrides infected skin from 18 percent of a patient’s body surface area (BSA), should I report 11000 x 2? The skin was on the left arm and trunk, extending to the upper left thigh.

AAPC Forum Participant

Answer: No, you shouldn’t go that route. On the claim, report:

  • 11000 (Debridement of extensive eczematous or infected skin; up to 10% of body surface) for the first 10 percent BSA debridement
  • +11001 (… each additional 10% of the body surface, or part thereof (List separately in addition to code for primary procedure)) for the remaining 8 percent BSA debridement

Exception: If the physician performs abdominal wall or genitalia debridement for necrotizing soft tissue infection, don’t use 11000/+11001. Instead, CPT® instructs you to use the following codes:

  • 11004 (Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum)
  • 11005 (… abdominal wall, with or without fascial closure)
  • 11006 (… external genitalia, perineum and abdominal wall, with or without fascial closure).