tci General Surgery Coding Alert - 2012 Issue 2

Reader Question: Note Must Lead Diagnosis Selection

Question: When I bill Medicare for deep debridement (11042) using the diagnosis the surgeon supplied -- 709.9 -- I'm getting denied payment. What diagnosis should I use for debridement?California SubscriberAnswer: You should use the diagnosis code that describes the patient's condition. You should never assign a code just because it is a "payable" diagnosis for the procedure (11042, Debridement, subcutaneous tissue [includes epidermis and dermis, if performed]; first 20 sq. cm or less). In this case, your surgeon has chosen a non-specific code (709.9, Unspecified disorder of skin and subcutaneous tissue), so you'll need to go...

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