Wiki Surgical debridement: Muscle/fascia CPT 11043, Bone CPT 11044

[becka95]

I code for outpatient wound care centers. On occasion, we will find documentation for a surgical debridement where devitalized tissue is removed (biofilm, slough, necrotic tissue) and other tissue such as tendon or ligament removed but no epidermis, dermis, subcutaneous tissue or muscle/fascia removed. Providers are marking these debridements as 11043. Based on the code description and the Codify lay term, the providers remove muscle/fascia. The tendon/ligament is not noted in the code description. Is it appropriate to code 11043 when only the tendon/ligament is removed with devitalized tissue?

What if the provider documents that they debrided only the joint capsule (including removal of devitalized/necrotic tissue)? They are reporting 11044 even if no epidermis, dermis, subcutaneous, muscle/fascia is removed

The patients have ulcers and the wound extends to the tendon/ligament or to the joint capsule. There are other orthopedic codes for debridement, however, these are open wounds and not debrided with the same approach as the arthroscopic debridements and many are included or add-ons to another procedure.

 

[nickelclaw]

yes 11043 for tendon, muscle, fascia, ligament
per Coder's Desk Reference the description of both 11043 and 11044 state that epidermis, dermis, etc. may be included but don't have to be for code selection.
These codes go by the depth of the debridement with the size being measured after debridement for code selection.
Make sure these aren't selective debridements as these are in the 99 category.