Urology Coding Alert

Question: How should we code an exploration of scrotum, perineum and inguinal areas with incision, drainage and excision of abscess, and placement of Penrose drains?

Montana Subscriber

Answer: This appears to be a case of Fourniers gangrene (608.83) of the perineum and scrotum. Incision, drainage and debridement of the above-mentioned areas would include 11042 (debridement; skin, and subcutaneous tissue) or 11043 (debridement; skin, subcutaneous tissue, and muscle), depending on the depth of involvement and drainage. These codes have a zero- and 10-day global fee, respectively. A repeated incision and drainage within the 10-day global requires use of modifier -58 (staged or related procedure or service by the same physician during the postoperative period), such as 11043-58. To use modifier -58, mention in your first incision-and-drainage report that a staged procedure may be required.

Answers to You Be the Coder and Reader Questions contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stonybrook, and urology coding trainer; Cynthia Jackson, RRA, CPC, coding specialist, Emory Clinic Urology Group, Atlanta; and Sandy Page, CPC, CCS-P, co-owner, Medical Practice Support Services, Denver.