Wiki Wound debridement after 10 day global

[g.fairchild]

We do not see this too often in our practice so I though I would throw this question out there. We performed a minor procedure on a patient that carried 10 day global....over one month after the procedure, the Physcian performed wound repair (?) under anesthesia. Can this be billed out, or is it considered a complication of the original procedure? Following is the op note: Thanks for the assistance....

....Following sterile draping of the patient the area of the back wound was explored. The dehiscence was found to be very superficial in nature. The deep suture line was completely intact. There were no signs of purulence, edema or any signs of infection. A culture was taken and sent off. Following this, both lateral edges of the incision were excised exposing clean tissue. These were then undermined slightly. ...antibiotic solution used to irrigate..incision was closed using three interrupted mattress sutures....etc ....

If this is considered wound repair, the Physician did not supply a cm measure....would it beconsidered debridement?

 

[Tianne]

you should definately bill for this. debridement during the global period is sometimes billable, but it is definatly billable outside the global period. CPT 11040 thru 11044 probably fits what you did....

 

[g.fairchild]

you should definately bill for this. debridement during the global period is sometimes billable, but it is definatly billable outside the global period. CPT 11040 thru 11044 probably fits what you did....

Thanks for the info...would you be able to tell me when debridement within the global period is billable....

 

[g.fairchild]

The more I think about this, would this not constitute an intermediate repair...it was done under general anesthesia, the debridement is included...correct??? They irrigated the wound with a Stryker power irrigator...

 

[FTessaBartels]

NOT debridement

You wrote: ....Following sterile draping of the patient the area of the back wound was explored. The dehiscence was found to be very superficial in nature. The deep suture line was completely intact. There were no signs of purulence, edema or any signs of infection. A culture was taken and sent off. Following this, both lateral edges of the incision were excised exposing clean tissue. These were then undermined slightly . ...antibiotic solution used to irrigate..incision was closed using three interrupted mattress sutures....etc ....


Not debridement; irrigation (even with pressure) is not debridement. Looks like simple repair to me. Even though there was some undermining you can't code complex repair unless there is "Extensive undermining" (per CPT description - pg 64 in 2010 professional edition).

You'll have to code to the smallest length unless he dictates an addendum giving you the length of the wound.

F Tessa Bartels, CPC, CEMC