debridement and layered closure billing
Overheard a coding discussion recently at a conference and I wanted to get opinions from others. Patient was receiving wound care on the thigh. The physician was doing debridement with wound vac covering. As the healing developed, the physician closed the layers of muscle/fascia as it became viable. The final closure had not happened yet so the coders were discussing how to bill for this. One coder stated to just bill it as debridement with the wound vac placement. Another coder wanted to use a sub-q closure code with debridement, but felt that could bundle. Apparently the physician felt the closures were the most important part, not the debridement but the coders disagreed. Anyone have opinions on how to bill for this scenario?
Mary Dressler, CPC, CEMC
T: 405-271-1500 ext. 54180 F: 405-271-2499 Email: mary-dressler@ouhsc.edu
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Mary Dressler, CPC, CEMC
T: 405-271-1500 ext. 54180 F: 405-271-2499 Email: mary-dressler@ouhsc.edu
Anonymous Hot Line
(405) 271-2223
(866) 836-3150
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain information that is confidential and/or privileged and is intended for the use of the individual or designated entity named above. If you are not the intended recipient, be aware any review, disclosure, dissemination, distribution, or copying of the contents is prohibited. If you received this email in error, please notify the sender immediately by a 'reply to sender only' message and destroy any electronic and hard copies of the email and attachments.
Comments
Mary Dressler, CPC, CEMC
It's really hard to tell without reports.
ws.com
Ruby Woodward
Sent from my iPhone
Mary Dressler, CPC, CEMC
From: Ruby Woodward [mailto:rubywdwrd@gmail.com]
Sent: Friday, May 05, 2017 6:31 PM
To: Multiple recipients of list PARTB-L
Subject: Re: [partb-l] debridement and layered closure billing
Good scenario. Debridement is included in the closure and extensive debridement allows you to bump it up to complex but in this case not appropriate if no closure. Since the wound is technically still open and a vac is being used maybe the 150xx series would be the way to go. It is preparation and a vac is being used. Not sure you could use repair or secondary closure codes in stages.
Ruby Woodward
Sent from my iPhone