Orthopedic Coding Alert

Question: May I bill debridement if the physician documents no gross contamination? The physician reduced an open tibia fracture, applied an external fixator, and performed irrigation and debridement.

Minnesota Subscriber

Answer: The short answer is “Yes.” Your payer will most likely allow you to report the appropriate debridement code from the 11010-11012 series (Debridement including removal of foreign material  associated with open fracture[s] and/or dislocation[s] …) as well as 27752 (Closed treatment of tibial shaft fracture [with or without fibular fracture]; with manipulation, with or without skeletal traction).

When reporting codes 11010-11012, the surgeon must document that he removed devitalized tissue using a surgical instrument; simply irrigating out the fracture site does not qualify.

Don’t miss: You may also report a code such as 20690 (Application of a uniplane [pins or wires in one plane], unilateral, external fixation system) to reflect the surgeon’s work applying the external fixation device to the patient’s leg. Note: CPT 2008 removes 20690’s modifier 51 (Multiple procedures) exempt status because the service is already subject to Medicare multiple-surgery payment reductions and requires significant pre- and post-service work.