General Surgery Coding Alert

You can report debridement (for example, 11040, Debridement; skin, partial thickness) during the same session as an Unna boot (29580, Strapping; Unna boot), but only if the debridement and Unna boot occur in separate anatomical areas (in other words, on separate legs).

The December 2005 General Surgery Coding Alert (-Everything You Need to Kick Up Your Unna Boot Reimbursement-) did not mention that the National Correct Coding Initiative (NCCI) does not allow you to report debridement and Unna boot strapping for the same leg.

-Since 1999, NCCI has bundled column 2 code 29580 into column 1 codes 11040-11044 as a standard of medical/surgical practice,- says keen-eyed reader Jo Ann F. Kergides, CPC-H, physician services coder at UMDNJ-SOM Vascular Surgery in Stratford, N.J. -If the treating physician performs a debridement and then applies an Unna boot, the Unna boot is inclusive to the debridement.-

The edit does contain a modifier indicator of -1,- Kergides goes on to say: If the physician performs a debridement on the patient's right foot and applies an Unna boot to the left foot, you may report both services with modifier 59 (Distinct procedural service) appended to 29580.