Question: My urologists did an extensive four-hour debridement of Fournier's gangrene involving the penile skin, scrotum, and a portion of the perineum. They also did extensive debridement into the flank, the space of Retzius, the prevesical space, and the retroperitoneum including the area of the great vessels. And they performed a right radical orchiectomy and inserted a suprapubic tube. I am aware that there are new codes available for Fournier's debridement in 2005, but this happened on Dec. 29, 2004. Tip: The retroperitoneal dissection is the highest paying code, and this should be listed first.
Maine Subscriber
Answer: Since the date of service was in 2004, you won't be able to use the new Fournier's debridement found in the 2005 CPT Manual. Instead, report the following CPT Codes:
You could also append modifier -22 (Unusual procedural services) to 49060 or 11043, but this would probably complicate the issue more for the carrier and hold up payments.