Urology Coding Alert

Question: I'm coding for the following report: An elliptical incision was made in the right hemiscrotum to remove a necrotic patch on the scrotum. The urologist then debrided tissue until he reached healthy tissue that bled. He used his finger to break up any loculations. The urologist then made a counter incision in the right inguinal region and debrided tissue along that tract. He placed a Penrose drain along this tract and packed the entire wound. The procedure was completed by debriding the perineum.

My physician coded this as 55100 but I think 111004 is more appropriate. What is your recommendation?

Maine Subscriber

Answer: You are correct in thinking 55100 (Drainage of scrotal wall abscess) is not the best code for the procedure you describe.

Instead, report a code for debridement based on the anatomic location treated:

• 11004 – Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum
• 11005 – ... abdominal wall, with or without fascial closure
• 11006 – ... external genitalia, perineum and abdominal wall, with or without fascial closure.

Of these options, code 11006 would appear to be the most accurate choice based on your description.

Also note: CPT^® offers a clue that points you in the right direction. A coding guideline with 55100 states, "For debridement of necrotizing soft tissue infection of external genitalia, see 11004-11006."