Orthopedic Coding Alert
Clear Away Your Debridement Questions
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 basic answer to this 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).
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.
Keep in mind: The Correct Coding Initiative (CCI) bundles code 11010 with 20690. Also, in order to report an open fracture debridement code, the documentation must describe more than irrigation of the open fracture site. The orthopedist must document that he removed the devitalized tissue.
Related Articles
Orthopedic Coding Alert
- Elbows:
Stay in the Game With the Correct Ligament Repair, Reconstruction Codes
Remember ligament repair abbreviations to simplify elbow ligament surgery coding. If conservative therapies fail to [...] - ABN:
Protect Your Epidural/Spinal Injection Pay With ABNs
Heres when to append modifiers GA, GY, and GZ. Services a patients insurer doesn’t cover [...] - ICD-10:
Here's How to Capture Carpal Tunnel Coding With Your New Diagnosis System
Don’t miss this Excludes1 note under the G56 category. When your orthopedist treats carpal tunnel [...] - Reimbursement News:
Look Beyond Code Changes to Billing and Policy Updates
CMS pulls back on some proposed changes. With ICD-10 and CPT® code changes on the [...] - Reader Question:
CMS's Billing Software Won't Eliminate ICD-10 Conversion
Question: I have heard that Medicare has created free billing software that will let us get [...] - Reader Question:
Resolve Secondary Payer Issues With Conversations
Question: Our doctor performed surgery on a patient 11 months ago. We just learned that the [...] - Reader Question:
Tackle 25606 and 25607 Bundle
Question: One of our physicians did an “open reduction and percutaneous pinning of the right distal [...] - You Be the Coder:
Clear Away Your Debridement Questions
Question: May I bill debridement if the physician documents no gross contamination? The physician reduced an [...]
