Get expert wound care answers.
Inaccurately coding wound care claims can result in a
breakdown in your bottom line. Go through these wound care questions and
answers to decide if your wound medical coding knowledge means a quick reimbursement
or necessitates immediate treatment. Read this article for accurate medical
coding.
Question #1: In case your podiatrist examines a patient in
the ED to treat a hunting gunshot wound in the foot that involves broken
metatarsal bones that the podiatrist should repair in the operating room,
should you report the tissue or bone injury and repair as the primary diagnosis
as well as the procedure?
Answer: A gunshot wound to the foot is actually a
high-velocity wound that is likely to have fractures and needs an aggressive
washing along with cleaning of the wound owing to contamination from sock and
shoe material and dirt.
Based on the condition above, you're also going to have to
do multiple debridements.
The rules state you must list things in order with the
procedure that makes use of the most time and skill for that needed service
first. In this scenario, the debridement of the open compound fracture would
take preference, as it's a bigger code in terms of RVUs.
Consequently, for accurate medical coding, you would code
the wound as 1101x (Debridement including removal of foreign material at the
site of an open fracture[s] and/or dislocation[s]...) associated with diagnosis
code 892.1 (Open wound of foot except toe[s] alone; complicated), as well as
28485 (Open treatment of metatarsal fracture, includes internal fixation, when
performed, each) related to 825.30 (Fracture of unspecified bone[s] of foot
[except toes]; open).
Question #2: What codes should you report for compression
therapy for patients who have venous stasis ulcers?
Answer: There's no individual code for compression therapy
for venous stasis ulcers because there is for statin therapy. Podiatrists carry
out treatment for venous stasis ulcers with a number of modalities according to
the situation. For instance the Unna boot, for which you may only report the
application of the boot (29580, Strapping; Unna boot), however not the boot
itself.
Other modalities involve Ace wraps along with compression
markers (HCPCS code A6449, Light compression bandage, elastic, knitted/woven,
width greater than or equal to 3 in. and less than 5 in., per yard) as well as
Profore, which is a multi-layer compression bandage system.
Medical Coding Tip: Report Profore along with 29580, and
then think of appending modifier 22 (Increased procedural services) to explain
for the multiple layers that the podiatrist should apply. You must then link
the CPT® code to ICD-9 code 454.0 (Varicose veins of lower extremities; with
ulcer).
Venous stasis wounds are caused when the veins in the lower
leg don't work so well and you get leakage of venous blood and swelling of the
legs. The ulcers are a consequence of the poor blood exchange and the swelling.
