General Surgery Coding Alert

Question: The surgeon performed debridement for a burn case that involved removing eschar beyond the fascia into subcutaneous tissue for a 12.3 sq cm area on the left thigh and a 14.7 sq cm area on the abdomen. How should we code this?

North Dakota Subscriber

Answer: Because the surgeon debrides into the subcutaneous tissue beneath the fascia, you should turn to 11043 (Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less).

Don’t: Even though the surgeon works at two sites, each of which is less than 20 sq cm, you should not code 11403 x 2.

Do: For debridement services on the same date, you should add together the treated areas of the same debridement depth. In this case, the surgeon debrided both areas into subcutaneous tissue. When you add the areas together, you get a total area of 27 sq cm. In addition to 11403 for the first 20 sq cm, you should additionally report +11046 (… each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)).