tci ED Coding & Reimbursement Alert - 2006 Issue 5

You Be the Coder: Get Specific With New Decubitus Ulcer Diagnoses

Question: A patient with decubitus ulcers on his right hip and buttock presents to the ED. The physician debrides partial skin from the right hip, and skin and subcutaneous tissue from the buttock. How should we report this encounter, and should there be more than one ICD-9 code?Michigan SubscriberAnswer: This encounter should include a pair of ICD-9 codes: one for each debridement. Since 2004's installment of ICD-9, the diagnosis codes for decubitus ulcers have included a fifth-digit classification that describes the wound's location.On the claim, you should:- report 11042 (Debridement; skin, and subcutaneous tissue) for the buttock...

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