Wiki Wound Coding

[ihadaball]

Hello, I really need some help with understanding the new LCD's for Wound. I have copy and pasted the following:

When performing debridement of a single wound, report depth using the deepest level of tissue removed. In multiple wounds, sum the surface area of wounds that are the same depth, but do not combine wounds from different depths. This A/B MAC allows payment for an aggregate total of one independent tissue debridement on a given day of service. Any number greater than the aggregate total of four for one or both feet per date of service will result in a denial which may be appealed with documentation justifying the additional services. Once debridement is properly done repeat debridement is not expected for several days afterward.

The items in RED I am not sure how to interpret. The way I am reading it is that we are only limited to one debridement on any given visit no matter how many ulcers were debrided. The one about the feet I am assuming we are not supposed to code any more than 4 ulcers in one given visit between both feet.

Thank you for your help.

 

[espressoguy]

This is not new. To code for ulcer debridement you add up the total sq cm of all of the ulcers of the same depth. For example, say there is a left calf ulcer measuring 8cm x 6cm, a right calf ulcer measuring 6cm x 4cm, a right toe ulcer measuring 3cm x 3cm a left ankle ulcer measuring 4cm x 4cm.

The provider does a subcutaneous debridement of all four ulcers. This is a total of 97 sq cm. This would be coded as 11042, 11045(x4). This will be denied as this is greater than 4 units. Assuming the documentation supports the 5 units, this will be paid on appeal.

If there were additional ulcers debrided at other depths, you would code those as well.