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Debridement Coding
If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as 11042 and 11042-59 or 11042 RT and 11042 LT?
Question:
If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as 11042 and 11042-59 or 11042 RT and 11042 LT?
Answer:
If debridement is performed at the same depth of tissue (all subcutaneous tissue) it is summed to arrive at the appropriate codes, even if in different anatomic areas. So, in your example, the codes would be 11042 and the add-on code 11045 for the 30 sq. cm of debridement. See the codes below.
11042 Debridement,subcutaneous tissue(includes epidermis and dermis, if performed); first 20 sq. cm or less
11045 each additional 20 sq. cm, or part thereof (List separately in addition to code for primary procedure)
*This response is based on the best information available as of 12/15/22.
Coding for Trauma Resuscitation
How do we bill for a trauma resuscitation? Are there codes for hanging fluids and packed cells? Can we use the CPR code 92950?
Question:
How do we bill for a trauma resuscitation? Are there codes for hanging fluids and packed cells? Can we use the CPR code 92950?
Answer:
There is no specific code for a trauma resuscitation or for administering fluids or blood products. The CPR code is specifically for providing cardiopulmonary resuscitation; chest compression, airway support. Trauma resuscitation is best reported with a critical care code.
*This response is based on the best information available as of 12/01/22.
What Does “Separate Procedure “Mean in a CPT Code Description?
What does “separate procedure” mean when it follows a CPT code description?
Question:
What does “separate procedure” mean when it follows a CPT code description?
Answer:
Per CPT: Some of the procedures or services listed in the CPT codebook that are commonly carried out as an integral component of a total service or procedure have been identified by the inclusion of the term “separate procedure.” The codes designated as “separate procedure” should not be reported in addition to the code for the total procedure or service of which it is considered an integral component.
However, when a procedure or service that is designated as a “separate procedure” is carried out independently or considered to be unrelated or distinct from other procedures, report the code in addition to other procedures/services by appending modifier 59 to the specific “separate procedure” code. This indicates that the procedure is not considered to be a component of another procedure, but is a distinct, independent procedure. This may represent a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries).
What does this mean in practice?If a code description includes the term “separate procedure”, if that procedure is in the same anatomic area as a more comprehensive procedure (for example, lyse of adhesions followed by a colectomy) only the more comprehensive procedure, the colectomy, is reported.
*This response is based on the best information available as of 11/17/22.
Laparoscopic Pyloroplasty
How is a laparoscopic pyloroplasty reported? Can I use code 43800, Pyloroplasty?
Question:
How is a laparoscopic pyloroplasty reported? Can I use code 43800, Pyloroplasty?
Answer:
No, codes without the term laparoscopic in their description are intended as open codes and 43800 is an open code. There is no laparoscopic code for pyloroplasty so an unlisted code 43659 unlisted laparoscopic procedure, stomach, must be used.
*This response is based on the best information available as of 11/03/22.
Peritoneal Catheter Placement
I placed the peritoneal catheter for a neurosurgeon placing a V-P shunt. Do I code 49419, insertion of peritoneal catheter?
Question:
I placed the peritoneal catheter for a neurosurgeon placing a V-P shunt. Do I code 49419, insertion of peritoneal catheter?
Answer:
No, you are a co-surgeon with the neurosurgeon. Code 62223, creation of a ventriculo -peritoneal shunt, includesboth the neurosurgeon’s portion of placing the ventricular catheter and your portion of placing the peritoneal catheter. Both surgeonswill report 62223-62.
*This response is based on the best information available as of 10/20/22.
Co Surgeon or Assistant?
A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case?
Question:
A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case?
Answer:
Neither. The vascular surgeon will report his work, repair of vessel, and you will report yours.
*This response is based on the best information available as of 10/06/22.