General Surgery Coding Alert
Unna Boot Faces New Bundles
The latest version of the Correct Coding Initiative (14.1) introduces several new bundling edits involving Unna boot application (29580, Strapping; Unna boot). Specifically, CCI now bundles several additional integumentary procedures to 29580, including: - 10061 -- Incision and drainage of abscess; complicated or multiple - 10140 -- Incision and drainage of hematoma, seroma or fluid collection - 10160 -- Puncture aspiration of abscess, hematoma, bulla or cyst - 11000 -- Debridement of extensive eczematous or infected skin; up to 10 percent of body surface. The CCI justifies the edits as being consistent with "CPT Manual and CMS coding manual instructions" -- that is, the edits merely reinforce longstanding correct coding principles. However, these edits only apply if the surgeon performs the bundled procedure and places the Unna boot at the same location. Therefore, for instance, if the surgeon placed an Unna boot on the left leg but performed an incision and drainage of a hematoma on the right leg, you could report both 29580 and 10140, with modifier 59 (Distinct procedural service) on the latter code to show the separate location. CCI 14.1 also deletes the edit bundling simple repair codes 12002 and 12004 to Unna boot strapping. Should the surgeon repair superficial wounds of 2.6 cm or more, even at the same location as placement of the Unna boot (29580), you may now report the wound repair separately, under CCI guidelines.
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