tci General Surgery Coding Alert - 2009 Issue 11

Reader Question: Skip VAC Code With 11005

Question: When I billed a wound VAC code to Medicare along with a debridement (11005), Medicare denied the wound VAC code. The diagnosis I used was covered under the LCD for Medicare. Can I appeal this? Texas Subscriber Answer: Most likely, your surgeon performed this procedure in the hospital. In that case, you won't be able to appeal this denial successfully. Medicare has bundled negative-pressure therapy, or vacuum-assisted  drainage collection (often shortened to VAC or VAD) placement (97605-97606, Negative pressure wound therapy [e.g., vacuum assisted drainage collection], including topical application[s], wound assessment, and instruction[s] for ongoing care, per...

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