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EK226

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Hello!

I have a question about CPT code 15852. The description reads "dressing change (for other than burns) under anethesia (other than local)." I am reviewing op notes for a date of service of 12/28/09 and the assesment states: 1. Superficial Debridment right foot , 2. Application of sterile dressing.

It appears that on 12/22/09 a different physician treated the patient for 28825 "partial amputation of the toe" and also was treated for 11043 "skin debridment-subcutaneous skin, muscle".

The physician who billed for services provided on 12/28/09 only billed 15852, and I am being questioned as to why the physician does not bill for a debridment procedure also. I noticed that the intial procedures performed on 12/22/09 have a 90 day and a 10 day global period, so is that why the physian is only billing for the dressing change? Wouldn't the dressing change (15852) be considered/included as part of the debridment procedure (11043) anyways; or is it considered separate procedure to bill since anesthesia had to be administered?

Any thoughts on this one??
 
BIll the debridement

It would be best to see the actual procedure note to be certain. From the title of "superficial debridement" it is possible that what was performed did not meet the requirements for 11043.

But if the debridement was in fact performed, you would correctly bill the debridement and not the dressing change.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
15852

Hello,

Yes it does help a little bit. I'm wondering about 15852, they way I interpret it is that it is not included in the debridment procedure, and in fact could be billed by itself--if it was truly the only thing performed this day?

The basic parts of the procedure note state: The necrotic-appearing skin edges were debrided along with the blisters in order to decompress them to provide less media for bacterial infection. The patient's wound did not appear infected and was, therefore, not opened today. The area was dressed with Xeroform, 4 x 4s, Kerlix and a well-padded dressing using cotton and ACE wrap for bulky immobilization. The patient was revived from anesthesia and taken to postanesthesia care unit in a stable condition.

So my thoughts are since the doctor states the wound was not opened would that justify the reasoning behind the debridment not being billed?
 
Dressing change

Yes, since the wound was not opened and this was truly "superficial" I would code ONLY CPT 15852 - dressing change (not for burns) under anesthesia.

If there truly had been a debridement of skin and subq tissue (or even further with muscle and/or bone), then you would code the debridement WITHOUT the dressing change.

The dressing of surgical wounds is included in the basic procedure, so unless you had two completely separate wound sites, the dressing would NOT be separately billable.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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