*This response is based on the best information available as of 09/05/19. Skin substitute graft codes are not to be reported for application of non-graft wound dressings (e.g., gel, powder, ointment, foam, liquid) or injected skin substitutes. 0000000936 00000 n If more than 44-sq. Here's How to Choose : Either Debridement or Excision Is - AAPC PDF Billing and Coding Guidelines: Contractor Name - Centers for Medicare Skin substitute grafts include the following: All rights reserved, Debridement of the skin that is preparatory to further surgery such as reduction of fracture, etc., should not be coded as a separate procedure., The surgeon debrided the necrotic tissue surrounding the amputation site, harvested skin from the patient's thigh and closed the wound with a split thickness skin graft. damages arising out of the use of such information, product, or process. %%EOF Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. HLN>bE+hAi .xiJ2D4>"A_6N@f("nChK!`=x;c` DIS!Sf8_c^x)$ 4 Quick Tips for Debridement Coding - AAPC Knowledge Center Coding matrix for the new skin substitute graft codes For multiple wounds, sum the surface area of all wounds requiring grafts from the same anatomic site and report the applicable primary code and add-on code in multiples, as appropriate. Debridement services are now defined by body surface area of the debrided tissue and not by individual ulcers or wounds. What are the 2020 CPT code changes? 0000017393 00000 n CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. /| cm). In addition to the type of graft material, the surgeon should also document site preparation and wound size, and number and location of grafts, according to Beresh. This email will be sent from you to the Is this right? All rights reserved. Secondary Payor Doesnt Recognize Consultations. F(P.Q@/Q _(g RyfJwE@~:_t4lGY@iYTSBd(m6 DZk0XGxmpP+pF+ff,rBQ*A-E;qkdKom`5!0>?|;!Qb5(Hj QPiX)=Zc4cgQ+*lri59? Peruse CPTs Skin Replacement Surgery section, and youll see that the guidelines mention different types of skin grafts. You can collapse such groups by clicking on the group header to make navigation easier. That means you should select the appropriate HCPCS Level II code such as Q4101 (Apligraf, per square centimeter) or C1763 (Connective tissue, non-human (includes synthetic)) for the graft material. 25 0 obj <> endobj Supplies such as A6453 (Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard) are included in the skin application charge. 4. This article was converted to the new Billing and Coding Article format. ICD-10-PCS CODING 2022 - Case Studies and Code Building Exercises.docx and monitoring is occurring. Anesthesia administered by or incident to the provider performing the debridement procedure is not separately payable. x-ray), and treatment of any infection by antibiotics. CPT codes 11000 and 11001 are not appropriate for debridement of a localized amount of tissue normally associated with a circumscribed lesion. Non-human skin substitute grafts such as xenografts (from another animal such as pig) The physician documentation is the key to being able to support both codes. You need to master the different graft options and know how to find the information in the surgeons note, because CPT includes different code sets for each type of graft. Complete documentation for excisional debridement requires five elements, including: i. Skin replacement surgery consists of two basic steps: surgical preparation of the recipient site and placement of the graft with fixation. 0000012252 00000 n Question: 1 See CPT coding guidance for proper use of the coding. By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. Reproduced with permission. Remember that the debridement codes, 11042-11047, are reported when you debride an open wound that will stay open to heal by secondary intention. For example, debridement of two ulcers on the foot to the level of subcutaneous tissue, total area of 6 sq cm should be billed as CPT code 11042 with unit of service of 1. Skin Lesion Excision Wait for Pathology? R'7bd snYJ@ 9PE@ cL endstream endobj 44 0 obj <>>> endobj 45 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Tabs/W/Thumb 35 0 R/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 46 0 obj [/ICCBased 68 0 R] endobj 47 0 obj <> endobj 48 0 obj <>stream ,P* &r4DH#.|QW" ss Draft articles have document IDs that begin with "DA" (e.g., DA12345). cm and then debridement codes (with an appropriate modifier) for the remaining 65 sq. Coding and Billing for Skin Substitute Grafts Skin substitute graft application code selection is based on defect site location and size. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. CPT considers debridement a separate procedure only when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure. PDF Billing and Coding Guidelines - Centers for Medicare & Medicaid Services Supportive Documentation Requirements (required at least every 10 visits) for 97597 and 97598: Medical records must be made available to Medicare upon request. cm and not just that the size of the skin substitute was 20 sq. These codes are used for wound debridement but only when you are debriding an open wound with no intention of closing it; you expect the wound to heal by secondary intention. Size: To determine the surface area for code selection, add all areas within the same anatomic grouping, if the surgeon prepares multiple wounds. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Integumentary Procedures: 3 Tips Guide Coding for Skin Substitute Grafts, 3 Tips Guide Coding for Skin Substitute Grafts, Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (, 15002 and +15003 for trunk, arms, legs (including wrist or ankle), 15004 and +15005 for face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, Non-autologous human skin (dermal or epidermal, cellular and acellular) grafts, including allografts (from a person other than the patient) and homografts (from cadavers), Non-human skin substitute grafts such as xenografts (from another animal such as pig), Biological products that form a sheet scaffolding for skin growth. 2. The following products may be billed with CPT codes 15430-15431 . article does not apply to that Bill Type. Any other conditions that may significantly affect wound healing should also be appropriately addressed in the medical record. When can I report debridement separately? John Verhovshek, MA, CPC, is a contributing editor at AAPC. There are lessons to be learned to avoid damaging coding habits. For services related to removal of callus (hyperkeratotic tissue) around an ulcer, paring or cutting of corns, trimming or debridement of nails, please refer to NGS LCD Routine Foot Care and Debridement of Nails (L33636). CPT codes 97597 and 97598 are categorized by CMS as sometimes therapy services. If a physician uses a curette to debride slough on the surface of the wound is that classified as subcutaneous or non-surgical? Report 97597 for ulcer debridement down to the subcutaneous tissue. 11012 skin, subcutaneous tissue, muscle fascia, muscle and bone. You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. Service: The work described by these codes involves preparing a clean, viable wound surface for graft placement to heal by primary intention (not secondary intention). If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. 2021 Evaluation and Management Codes: Is a History Required? To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom Distinguish the codes based on body site, as follows: 0000011649 00000 n Please visit the. In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths. Applicable FARS\DFARS Restrictions Apply to Government Use. The CMS.gov Web site currently does not fully support browsers with Rather, it is removal of devitalized tissue, necrosis, and slough by other methods, including: Examples of non-excisional debridement are pulsed lavage, mechanical lavage, mechanical irrigation, high-pressure irrigation, etc. Like the site preparation codes, CPT distinguishes these codes by anatomic site and wound surface area, as follows: o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm Codify Subscriber Answer: You should [], Copyright 2023. Answer: Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). 0000018702 00000 n Bilateral Carpal Tunnel Procedures Different Days, Multiple Laminectomies to Place a Spinal Cord Stimulator. If billed by a hospital subject to OPPS for an outpatient service, these CPT codes will be paid under the OPPS when the service is not performed by a qualified therapist and it is inappropriate to bill the service under a therapy plan of care. 0000002478 00000 n When to Code Debridement As a Separate Procedure hbbd``b`uw@D`9$-$:@3AJT,$ fdgX*0L@6b``,O M You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, 0000006208 00000 n Follow our experts tips to make sure you select the proper code and get all the pay your surgeon deserves for these services. Even a minor breach of patient protected health information (PHI) or [], Question: We have a new surgeon in our practice who specializes in vascular surgery, and [], Question: When our surgeon rounds on a patient in the critical care unit, can we [], Question: When and how should we use external cause codes? "JavaScript" disabled. Sign up to get the latest information about your choice of CMS topics in your inbox. cm involved a skin substitute application, you can report 15271 for the 20 sq. CMS and its products and services are not endorsed by the AHA or any of its affiliates. If the surgeon leaves the wound open, you will report a debridement (11040-11044) rather than an excision. The views and/or positions Bottom line: Accurately coding skin substitute grafts requires lots of specific information in the medical record. That means you should never report 97602 (Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session) in addition to skin graft site preparation codes. Include dressing: You might find documentation of wound dressing in the op report for skin substitute grafts, but you shouldnt separately code routine dressing supplies for services performed in the office, according to CPT instruction. 11042 for a Stg III Pressure Ulcer, and for a separate much deeper Stg IV Pressure Ulcer, 11043, will not pay together, despite using Mods 59 and 58 for both with our twice-weekly, excisional surgical debridement. Medicare contractors are required to develop and disseminate Articles. To code the excision, look in the index for the term Lesion, then Skin. The National Correct Coding Initiative (NCCI) bundles skin substitute graft codes 15271-+15277 with skin and subcutaneous debridement code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less). My plastic surgeon debrided an open burn wound that was 45 sq cm then placed a split thickness skin graft over the wound. cm and documented 20 sq. When subcutaneous tissue is debrided from a 16 s. cm dehisced abdominal wound and a 10 sq cm thigh wound, report 11042 for the first 20 sq cm and 11045 for the second 6 sq cm. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816. Article - Billing and Coding: Wound Application of Cellular and/or End Users do not act for or on behalf of the CMS. All rights reserved, CMS publishes FAQ on modifiers -JW and -JZ, 2023 Revenue Integrity Symposium Justification Letter, 2023 NAHRI Leadership Council participation requirements, 2023 NAHRI Leadership Council research survey released. *This response is based on the best information available as of 11/16/17. Application of Bioengineered Skin Substitutes and Skin Grafting is performed on ulcers that are free of . 8u-0=*.tCOeF8h`TLeHRzLco`@X(d9rFdcG VA,P&l Add together the surface area of multiple . Coding for skin replacement surgery in 2012 | The Bulletin If the provider is unable to use photographs for documentation purposes, the medical record should contain sufficient detail to determine the extent of the wound and the result of the treatment. This Agreement will terminate upon notice if you violate its terms. Skin substitute graft application code selection is based on defect site location and size. trailer <<1D25FBD66AB6418699B8EC89A49470A5>]/Prev 196840>> startxref 0 %%EOF 74 0 obj <>stream will not infringe on privately owned rights. 0000010293 00000 n an effective method to share Articles that Medicare contractors develop. 0000017002 00000 n To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. Article document IDs begin with the letter "A" (e.g., A12345). cm. These codes are primarily used when irrigation and . Remember: Wound surface area is what you should consider when selecting the code, not the size of the graft, cautions Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan. End User Point and Click Amendment: cm. You can use the Contents side panel to help navigate the various sections. If the wound is being excised, not just debrided, at the time of split thickness skin graft placement then you could also report a surgical preparation code (e.g., 15002, 15004) in addition to the skin graft code. The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered. There are different article types: Articles are often related to an LCD, and the relationship can be seen in the "Associated Documents" section of the Article or the LCD. endstream endobj startxref Another option is to use the Download button at the top right of the document view pages (for certain document types). o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children), o Similar code pairs based on area: 15275 and +15276; 15277 and +15278. The program covers drugs that are furnished "incident-to" a physician's service provided that the drugs are not "usually self-administered" by the patient. 0000006836 00000 n culture and sensitivity), osteomyelitis (e.g. cm or less). Addition to Skin Graft Codes 15271-15278 is the new CPT code series for skin substitute grafts. Auto- is different: If you see the term autograft or tissue cultured autograft, then you are dealing with the harvest and/or application of an autologous skin graft. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. Copyright © 2022, the American Hospital Association, Chicago, Illinois. Based on what I have read in the Official Guidelines for Coding and Reporting and Coding Clinic for ICD-9-CM, I believe that I should report two separate codes. Debridement is considered a separately reportable procedure when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue is removed, or when debridement is carried out separately without an immediate primary closure. The surgeon may choose to leave the wound open in anticipation that healthy tissue will grow over the ulcer site. While every effort has been made to provide accurate and In your example, you will be closing the wound. Please do not use this feature to contact CMS. Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. The objective of the procedure is to . Tip 2: Identify Type of Skin Substitute Graft As you can see, procedure code 86.69 (other skin graft to other sites) includes the debridement and closure of the amputation site via split-thickness skin graft. If the documentation supports that 20 sq. of every MCD page. hb```f``e`2jx Y8t00:00@9@ 6 jx not endorsed by the AHA or any of its affiliates. H|Wd5W5Re'c X!XFk4K|?>_/]%zWCBJ7 .`u}}`JWJz=^o\z9e~BT AT9 vqdYkh%BprY-.%V)["[n . I96w4Ak1;*8LMZI;Oe1\s &$W2DQY#"E"2$*85lm"HIl]JW)"4#F3^6F8?1HtaG]xuA*D::!83P|MnKC*{:?qk,nlG,d=atI'0 I2nC Face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/ or multiple digits Replacement material, graft size, multiple wounds all these factors and more [], Dont miss pregnancy impact. Instructions for enabling "JavaScript" can be found here. End User License Agreement: Non-autologous human skin (dermal or epidermal, cellular and acellular) grafts, including allografts (from a person other than the patient) and homografts (from cadavers) Youll find the codes for skin substitute graft procedures in the range 15271-+15278 (, o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm, o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children), Face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/ or multiple digits, You can still separately code for deep debridement that includes muscle and bone, says, Grasp measurement rules. Include cleaning: When the surgeon performs a simple cleansing of the wound, that service is included within the skin substitute procedure codes, according to CPT instruction. Answer: Local infiltration, metacarpal/digital block or topical anesthesia are included in the reimbursement for debridement services and are not separately payable. Copyright 2023 HCPro, a Simplify Compliance brand. cm of the total 85.25 sq. 0000010407 00000 n This note should describe the anatomical location treated, the instruments used, anesthesia used if required, the type of tissue removed from the wound, the depth and area of the wound and the immediate post procedure care and follow-up instructions. If infection has developed, the patient's response to this infection should be described. Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. recommending their use. Frequent skilled observation and assessment of wound healing are recommended daily or weekly to justify the skilled service. hbbd``b`J@ H0lV$ W0 y Coding Debridement Procedures - AHIMA Skin Lesion Excision Wait for Pathology? For instance, Versajet debridement is considered to be nonsurgical, mechanical debridement because it does not involve cutting away or excising devitalized tissue. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. Avoid: Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. complete information, CMS does not guarantee that there are no errors in the information displayed on this web site. U B( B>i ^6XPw1E_H*>4=i"U}`K}1~ymIoq=wza 0000002443 00000 n Wound Care | CPT Codes for debridement - CodingIntel Tip 1: Capture Site Preparation KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. Refer to NCCI and OPPS requirements prior to billing Medicare.For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.The diagnosis code(s) must best describe the patient's condition for which the service was performed. Youll find the codes for skin substitute graft procedures in the range 15271-+15278 (Application of skin substitute graft ). CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. hUmo0+q 0HUmIkN^D Wk$$[n;=AIWq@ When your surgeon treats a patient with appendicitis, you may find [], Planning can reduce consequences. You need to master the different graft options and know how to find the information in the surgeons note, because CPT includes different code sets for each type of graft. Medicaid and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration presented in the material do not necessarily represent the views of the AHA. is needed for additional grafting, bill according to the number of single units of Apligraf, Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. He is an alumnus of York College of Pennsylvania and Clemson University. Initial debridement may be deep and through skin, subcutaneous tissue, muscle fascia, and muscle. Privacy Policy | Terms & Conditions | Contact Us. %%EOF endstream endobj 26 0 obj <> endobj 27 0 obj <> endobj 28 0 obj <>stream accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the An operative note or procedure note for the debridement service. These unique codes are classified as per the anatomic site (general and specific body. Wound care debridement codes 1104211047 Use these codes when the only procedure performed in wound debridement. CPT codes, descriptions and other data only are copyright 2022 American Medical Association. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS, DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), Some older versions have been archived. rW`n":Q5g%_7:j)j9."QFGH(2My"hqt}%%l}]KkWmNhlI,(PjqK9%.v#|3^ya%h'e'e2iB@iFOk|q)7 If.ug q&QP;jNy>9cW=aB=je>m3/dDQMA;2VJ0E5&Qj2[iG"^l+E. 1 G/r f VY;fuC{r@,>^Q k1[1Q3#V^DJ;;j!E"&~'/;{1M, ~ B ^(\%@%t m+?Rh@yK Coding Debridement with Grafts - KarenZupko&Associates, Inc. The AMA does not directly or indirectly practice medicine or dispense medical services.