“What procedure codes represent the treatment of an abrasion? Are we restricted to E/M codes?”
In order to address and answer this question appropriately, it is important to first understand what an abrasion is. An abrasion is a superficial rub or wearing off of the skin, usually caused by a scrape or a brush burn. For the most part, it is a partial thickness wound caused by damage to the skin and can be superficial involving only the epidermis to deep, involving the deep dermis. Abrasions are coded in ICD-10 based upon whether they are infected or not infected.
Abrasion foot/toe, without mention of Infection:
S90.811- Abrasion, right foot
S90.812- Abrasion, left foot
S90.411- Abrasion, right great toe
S90.412- Abrasion, left great toe
S90.414- Abrasion, right lesser toe(s)
S90.415- Abrasion, left lesser toe(s)
Non-Fracture Seventh Character Codes:
A = Initial encounter
D = Subsequent encounter
S = Sequela
Abrasion foot/toe, infected
L08.89 Other specified local infections of the skin and subcutaneous tissue
L08.9 Local infection of the skin and subcutaneous tissue, unspecified
*use additional code to identify any infectious organism
For the most part, based upon how an abrasion is defined, it would be treated medically as opposed to procedurally. Therefore, the treatment of an abrasion will be coded and billed based upon the most appropriate level of E/M service. That being said, if an abrasion extends deep into the dermis resulting in necrotic tissue that needs to be excisionally debrided out from within the affected site, then the abrasion would be classified as a wound. And in this situation, since it is deep into the dermis, CPT 97597 would be the most appropriate CPT code to bill.
This is my opinion.
Michael G. Warshaw
DPM, CPC
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