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Debridement

Coding

Performing Nail Debridements

by Dr. Michael Warshaw, DPM, CPC

Can an Unlicensed Individual Perform Nail Debridements Under the License of a DPM and Can the Service be Billed to Medicare?
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Coding

Plantar Keratosis Combination

by Dr. Michael Warshaw, DPM, CPC

“Is the debridement of a plantar keratosis (CPT 11055) at the first metatarsal head considered bundled with nail debridement (CPT 11720)?”
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Coding

E/M Revisited

by Dr. Michael Warshaw, DPM, CPC

“For Medicare, it has been well established that debridement for callouses is not covered when class findings are not present. But what about that patient that complains of pain from a callus. If you evaluate the painful callus and manage the painful callus, would it not be appropriate to bill a low level E/M code? This patient does not want surgery but this is a recurring problem. Can the E/M be billed each time the patient is seen?”
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Coding

Combination of Services

by Dr. Michael Warshaw, DPM, CPC

“Is a plantar keratosis debridement (CPT 11055) at the first metatarsal head considered bundled with nail debridement (CPT 11720)?”
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Coding

Excision Gout Tophus

by Dr. Michael Warshaw, DPM, CPC

“The patient is a 47 year old with a soft tissue mass over the distal fibula. It appears to be a gouty tophus and x-rays show no bone involvement. What would be the proper code for surgical debridement/excision of this mass?”
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Coding

Debridement with Skin Substitutes

by Dr. Michael Warshaw, DPM, CPC

“Can one appropriately bill a debridement code, such as CPT 11042, each time when applying a skin substitute if indicated in a hospital, outpatient wound care clinic?”
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Coding

Debridement Codes

by Dr. Michael Warshaw, DPM, CPC

“My practice involves a lot of wound care and I frequently take patients to the operating room for a debridement involving a wound and bone with osteomyelitis. I always code this type of procedure as CPT 11043 and CPT 11044. I feel that this is justified because I am debriding the soft tissue structures (CPT 11043) but also the bone (CPT 11044). I was discussing this with a colleague and she suggested that this might not be appropriate.”
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Coding

Documentation Requirements for CPT 11721 continued

by Dr. Michael Warshaw, DPM, CPC

“I am trying to educate my physician about the documentation requirements for CPT 11721. He doesn’t think it’s important to document the number of nails debrided or even the method of debridement. Is there a resource you can point me to that specifically addresses this?” This was addressed last week. “Since it is stated – CPT 11721: Debridement of nail(s) by any method(s); 6 or more, why would it be necessary to document what instruments were used for debridement since any method would be accepted under this description?” This is part 2.
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Coding

Documentation Requirements for CPT 11721

by Dr. Michael Warshaw, DPM, CPC

I am trying to educate my physician about the documentation requirements for CPT code 11721. He doesn’t think it’s important to document the number of nails debrided or even the method of debridement. Is there a resource you can point me to that specifically addresses this?
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Coding

Onychomycosis Treatment

by Dr. Michael Warshaw, DPM, CPC

“Can you evaluate and manage onychomycosis without debridement for the purpose of treating onychomycosis for an established patient? This would be in the absence of pain and underlying conditions, specifically with Medicare patients. Is it a covered condition for just evaluation and management? Would tinea pedis be covered as a sole diagnosis for evaluation and management?”
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