wound care

  1. C

    Wiki Debridement (11042) of Sx Wound (T81.31XD)

    Hello, all. I am hoping this is the most relevant thread for this. I am billing for a starting wound care company that delivers wound care in nursing facilities. We are having trouble with multiple insurances, including Medicare, denying line items for debridement of surgical wounds (using CPT...
    • cberner
    • Thread
    • surgical wound wound care wound debridement
    • Replies: 2
    • Forum: Dermatology
  2. J

    Wiki Affinity Measurements

    Good morning! I am new to Podiatry coding, and have a question about how to code the Affinity membranes. I am trying to figure this out by going back and looking at previous coders work. INITIAL WOUND: 2/15 is 3 x 4 x .2 cm THIS VISIT: 4/26 wound size is 1.2 x .5 x .2 cm The only...
  3. R

    Wiki 17250 in Global Period

    I keep going back and forth on this. I have a patient who is status post mastectomy, and has been coming in weekly for post-operative visits. During these visits, the provider has been applying silver nitrate to the scar, but documentation states that the scar is healing normally. I'm of the...
  4. L

    Wiki Post Op Wound

    If the patient's incision develops a wound postoperatively (90-day global) and comes into the office weekly for wound care, can we bill for the debridement? Or is this considered part of the global package? Even though it's a complication and requires the patient to come in more frequently than...
    • lilyirecta@gmail.com
    • Thread
    • debridement global billing post op postop wound wound wound care wound debridement
    • Replies: 2
    • Forum: Podiatry
  5. Y

    Wiki Trauma Wounds in Diabetic patients

    I'm new to wound care coding and am still trying to figure out some of the particulars. My main struggle is with diabetic patients. If a diabetic patient has a trauma wound or pressure ulcer on the foot, is it still coded as a diabetic foot ulcer with E10/E11 and L97? OR Is the wound coded as...
  6. M

    Wiki Wound care referral to sx practice

    Question on compliance- my wound care dr who is employee'd as third party for our wound care center but has his own surgery practice (not affiliated with us). He is referring patients to have him perform surgery (thru his practice) at the hospital and then come back to our wound care for care...
  7. L

    Wiki Wound Manager Pouch - billable separately ?

    Hi all, My APNP replaced a "wound manager pouch." Is there a way to bill for it separately? I think it's bundled with the procedure as part of the closure, wound management care, but thought I'd check. The replacement of the pouch was performed a few days after the procedure because it was...
    • Lubovic
    • Thread
    • replacement of wound manager pouch wound care wound manager pouch
    • Replies: 1
    • Forum: General Surgery
  8. W

    Wiki 28003/28005 with 28120, 28122, 28222, etc

    I am new to podiatry coding. There is a physician billing 28003 and 28005 (which are NCCI bundled with the following)... 28122, 28062, 28222, 28120.... Mostly diabetic foot infection procedures for debridement/incision and drainage. Is it appropriate to bill the incision portion of the...
    • wkb4173
    • Thread
    • bundling debridement diabetic foot podiatry wound care
    • Replies: 3
    • Forum: Podiatry
  9. N

    Wiki Unrelated E/M with procedure

    Hi, general question... Is it appropriate to bill an E/M -25 when its unrelated to the primary procedure on every visit? It's not bundled due to both codes being unrelated. For example, patient comes in for debridement 11042 on right ankle, but provider treats edema in another area which is new...
    • nittamarable
    • Thread
    • e/m e/m with modifier 25 e/m with procedure evaluation & management followup modifier 25 ncci ncci edits unbundle wound care
    • Replies: 5
    • Forum: E/M
  10. S

    Wiki TCC

    Can a certified wound nurse perform and bill for CPT Code 29445 total contact cast? We are wondering if we can bill this out both on the professional side and facility side or if we just bill the professional side for the wound care nurse and then for facility charges bill for the supplies...
  11. A

    Wiki Wound Vac Question

    Can someone please advise if there is a separate code for DME Wound Vac Dressing Change or is it the 97605/97606? I thought this was only for the application of the wound vac or is the wound vac removed/applied for each dressing change? Thank you in advance.
  12. H

    Wiki Initial vs Subsequent Visit

    Patient banged leg and skinned it resulting in edema and shallow wounds. They may have visited another hospital/office (unclear in documentation) and kept a dressing on the leg, using hydrogen peroxide to clean it daily. However, the wounds have failed to progress and therefore was seen by their...
  13. T

    Wiki Time based E/M for Wound Care

    My Podiatrist is wanting to do time based billing on his Wound Care patients. These patients are mostly seen by nursing staff because they are just dressing changes. I have explained that you can not count the time spent by ancillary staff but he is not listening. Also, I was under the...
    • tvillarino
    • Thread
    • e/m changes wound care
    • Replies: 1
    • Forum: E/M
  14. S

    Wiki Wound Care

    I have a wound care question, I work with a wound care provider twice a week, he has always included a 99214(or applicable OV code) with his wound care codes, he has done wound care for a long time, he is now being told that after the first visit with the patient the only code is the...
  15. L

    Wiki Wound Packing without I&D by different provider

    I have a patient that had an I&D by a different provider, in fact a different health system all together. My doc saw this patient for repacking/dressing change. Anyone have a clue what CPT code I could use for this other than E/M?
  16. M

    Wiki Are we able to append modifier 59 if skin substitute and application is billed with E/M

    I work for a wound care clinic that often bills skins substitutes on the same date as an evaluation or other E/M codes. So I would like to know the proper way to bill this. Should we bill 992**-modifier 25, Q41**- modifier 59 and application 152**- modifier 59. Is this the correct way to bill this?
  17. M

    Wiki Application of free (pro bono) skin substitutes for Medicare.

    I work for a wound care clinic that applies free samples given to us by pharmaceutical rep to patients. I wanted to know if there's a way to receive reimbursement from Medicare for the application only. If so, how would I bill this? I attended a seminar that stated that modifier "FB" was...
  18. M

    Wiki Can we bill E/M codes on every routine wound care visit?

    I work for a wound care clinic that happens to also offer Hyperbarics treatment to patient with non healing diabetics wound, cosmetic abdominoplasty, hypospadias etc. Now I would like to know if the provider is able to bill and E/M code on every routine wound care visit. For example, patient...
    • mayra.zambrano
    • Thread
    • e/m and wound care e/m code help wound care
    • Replies: 4
    • Forum: E/M
  19. K

    Wiki Wound Care after EXCISION PILONIDAL CYST/SINUS COMPLICATED

    Patient was seen in our OR for EXCISION PILONIDAL CYST/SINUS COMPLICATED. The patient follows up weekly for wound care treatment. The wound clinic is in the same hospital as the OR and is being done by the same physician. The note states: "HPI: Patient presents to office for followup wound...
  20. M

    Wiki Wound Care and Wagner staging

    Really need a wound care coder for networking. How do I assign ICD-10 dx code to a Wager stage description. Please email. Thank you
  21. J

    Wiki Billing 12021 for wound care.

    I have a provider who keeps using CPT 12021 for packing a wound. My reading of the description tells me that this code is for wound dehiscence (for example, if sutures were removed & the wound split open, or an infection/abscess developed behind a surgical incision and kept it from healing)...
  22. A

    Wiki 11042-11047 Area of Partial Debridement

    Good Afternoon Everyone, This is my first post and question, I apologize if it is in the wrong forum section. My question is in regards to measuring the area of a debridement. From what I have read, it is measured by the "depth and the surface area of the wound". My question is what if only...
  23. B

    Wiki Epifix Application and Debridements

    We recently started using and billing Epifix in our wound care facilities. We use 15271 and 15272 (add on) as the application codes, with Q4131 as the product code. Our provider was wondering if debridement codes such as 97597, 11042, 11043, or 11044 could be billed with these codes or if they...
  24. G

    Wiki Dog Bite Wound Care

    Need a little clarification on coding a Dog Bite. We have a Healthcare office & Urgent Care all in one. This one came in under urgent care. Here is the notes from the encounter: Location: right lower leg posterior calf region. The wound was irrigated with sterile normal saline and debrided...
  25. L

    Wiki Debridement and Unna/Compression CPTs for different wound conditions

    I'm hoping you all can help me find some documentation that I've lost. My research found that if I have a Venous Insufficiency ulcer, I can code Debridement AND Unna/Compression with a -59 modifier because the Debridement is for the ulcer and the Unna is for the separation condition for the...
  26. S

    Wiki PLEASE HELP - Pre and post debridement measurements with callus

    I have providers in a podiatry clinic who are documenting 0 x 0 x 0 sq cm as the pre-debridement measurements when a callus is overlying an ulcer and then they document the size of the underlying ulcer post-debridement. They state that they cannot measure the wound before the debridement, since...
  27. J

    Wiki Ulcer wound care (debridement) and office visit

    I understand the modifier 25 issue - however, my doc's are concerned that when pt's are coming into our office for wound care (debridement of an ulcer) that they are losing money by not being able to bill an office visit with it. I have explained what the modifier means to them, but, their...
  28. D

    Wiki Excision of mass with closure/ complex repair

    The billing comes over marked 21933, 13101/59, 13102/59. A mass was removed the patient's flank, fine, but the surgeon has underlined this in the chart: A direct approximation of closure was not possible without creating significant additional deformity. Extensive undermining of skin and...
  29. B

    Wiki Wound Care Center

    I have been researching for specific info on billing when services are rendered in a Wound Care Center. My MD will be going to a Wound Care Center once a week for possible debridements to patients, could I still use the codes 11042-11047 with POS 11? POS 22? POS 49?
  30. K

    Wiki Surgical and selective debridement documentation requirements

    I'm auditing both surgical and selective debridement procedures (CPT11042-11047, 97597, 97598) and am finding the wound size is always documented, however it varies or is unclear if this measurement occurs before beginning the procedure or after the completion of the debridement. Is there a...
  31. S

    Wiki PLEASE HELP! Radiation soft tissue injury of the brain ICD-10 code(s)

    I am having trouble determining the correct ICD-10 diagnosis code(s) for "Radiation soft tissue injury of the brain". One of my providers is treating a patient for this condition with hyperbaric oxygen therapy. He also refers to the condition as "Radiation therapy induced brain necrosis". I have...
    • stormy78
    • Thread
    • 99183 g0277 hyperbaric oxygen therapy icd-10 wound care
    • Replies: 2
    • Forum: Diagnosis Coding
  32. C

    Wiki Wound Care Billing - Are there any (very) experienced

    Are there any (very) experienced or expert wound care coders available today for questions? I'm a experienced coder working in some new areas, one of which is wound care.
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