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Code This!

Scenario Week of February 04, 2011:
View Current Scenario

A patient presents to her dermatologist’s office with cellulitis of her foot caused by an unknown source, potentially a wood sliver. The dermatologist performs a 4 sq cm debridement of the skin of the foot using a scalpel, going only to the level of the dermis. The wound is appropriately dressed, and the patient will follow up with the physician in one week to check the progress of the wound.

How would this scenario be coded using 2011 CPT and ICD-9-CM codes?


CPT

97597Debridement (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

Prior to 2011, this code would not have been appropriate for surgical debridement of the skin, as there were surgical debridement codes available for skin-only debridements. However, in 2011 those codes were deleted, and skin-only debridements are now reported using the codes 97597 and 97598, depending on the size of the debridement performed.

Prior to 2011, codes 97597 and 97598 could not be reported together. With the 2011 change, 97598 became an add on code reported with code 97597. As a result, the CCI edit for these two codes expired on 12/31/2010.

ICD-9-CM

682.7Other cellulitis and abscess, foot except toes

It would be inappropriate to report any codes for the wood sliver or mechanism of injury because it is unknown exactly how the injury occurred.

 
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