Podiatry Coding & Billing Alert

Question: A patient reports to the podiatrist with decubitus ulcer that extends deep down into the fascia on her right heel. The physician then performs a debridement to treat the ulcers. What CPT and ICD-9 should I report?

Answer: You should report the services with 11043 (Debridement, muscle and/or fascia [includes epidermis, dermis, and subcutaneous tissue, if performed]; first 20 sq cm or less) for the heel debridement, and link 707.07 (Decubitus ulcer; heel) to show the location of the ulcer, according to CPT guidelines.

Remember: You should pick a debridement code (11042- 11044) if the surgeon leaves the wound open, rather than an excision. The surgeon may choose to leave the wound open in anticipation that healthy tissue will grow over the ulcer site. This method may require the surgeon to perform "staged" debridement as the wound heals. The physician performs an excision and closes the wound only if she sees no signs of infection.

Complete makes perfect: When debriding an ulcer, the surgeon should note not only the ulcer's location but also the debridement's depth/layers.