This info listed to assist Dr. W. with coding procedures
Musculoskeletal System: General
Aspirate Seroma
10160 puncture aspiration of an abscess, hematoma, bulla, or cyst. The palpable collection of fluid is located subcutaneously.
Integument, Debridement
11010 Debridement including removal of foreign material assoc with open fracture(s) and dislocation(s), skin and subQ tissue
11011 skin, subQ tiss, fascia, and muscle
11012 skin, subQ tiss, fascia, muscle, and bone
11040 debride skin, partial thickness
11041 debride skin full thickness
11042 debride skin, subQ tiss
11043 debride skin, subQ tiss, muscle
11044 debride skin, subQ tiss, mucsle, bone
96372 Injection (intramuscular or subQ), like for cortisone injection into the buttock done in office.
for 2011:
97597: Removal of devitalized tissue from wound(s), selective debridement without anesthesia (eg, high pressure waterjet with/without suction, sharp debridement with scissors, scalpel and forceps), with/without use of whirlpool, topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 20 square centimeters.
97598: Removal of devitalized tissue from wound(s), selective debridement without anesthesia (eg, high pressure waterjet with/without suction, sharp debridement with scissors, scalpel and forceps), with/without use of whirlpool, topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 20 sq. cm.
97605: Negative pressure wound therapy (e.g., vacuum-assisted drainage collection), including topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or equal to 50 sq cm.
97606: Negative pressure wound therapy…total wound(s) surface area greater than 50 sq cm, as with the debridgement codes, the 50 sq cm refers to total wound area, not a single large wound. To ensure accurate coding, include the wound’s measurements in the documentation—in metric measurements—so you can link it with the correct code.
Two new codes now avail (per SpineLine article Jan/Feb 2015) for applying disposable wound vacs:
97607: for surface area less than or equal to 50 sq cm.
97608: for surface area greater than 50 sq cm.
11042 now reads, “Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less.”
New add-on codes (11045, 11046, and 11047 for each additional 20 sq cm, based on the depth of the débridement) were introduced.
Repair, Simple
12001 superfic wounds of extremities or trunk, including hands and feet, 2.5 cm and less
12002 2.6-7.5 cm
12004 7.6-12.5 cm
12005 12.6-20 cm
12006 20.1-30 cm
12007 over 30 cm
Repair, Intermediate: Layer closure, extremities or trunk, excluding hands and feet
12031 2.5 cm and less
12032 2.6-7.5 cm
12034 7.6-12.5 cm
12035 12.6-20 cm
12036 20.1-30 cm
12037 over 30 cm
Repair, Intermediate: Layer closure, of hands and feet or neck
12041 2.5 cm and less
12042 2.6-7.5 cm
12044 7.6-12.5 cm
12045 12.6-20 cm
12046 20.1-30 cm
12047 over 30 cm
Repair, Complex: Reconstructive proced, complcated wound closure
13100 Repair, complex, trunk; 1.1-2.5 cm
13101 Repair, complex, trunk; 2.6-7.5 cm
13102 Repair, complex, trunk; each additional 5 cm or less
13120 Repair, complex, scalp, arms and/or legs; 1.1-2.5 cm
13121 Repair, complex, 2.6-7.5 cm
13122 Repair, complex, each additional 5 cm or less
Incision
20000 Incision of soft tissue abscess (e.g. secondary to osteomyelitis), superficial
20005 deep or complicated
Wound Exploration–Trauma (eg, penetrating gunshot or stab wound)
20100 Exploration of penetrating wound (separate procedure) neck
20101 chest
20102 abdomen/flank/back
20103 extremity
Excision
20150 Escision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision
(for aspiration of bone marrow, use 38220)
20200 Biopsy, muscle, superifcial
20205 deep
20206 Biopsy muscle, percutaneous needle
20220 Biopsy, bone, trocar or needle, superficial (eg. ilium, sternum, spinous process, ribs)
20225 deep (eg, vertebral body, femur)
Revised codes as of 1/1/17:
20240 – Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)
20245 – Biopsy, bone, open; deep (eg. Humeral shaft, ischium, femoral shaft)
20250 Biopsy, vertebral body, open, thoracic
20251 lumbar or cervical
(for sequestrectomy, osteomyelitis, or drainage of bone abscess, see anatomical area)
Introduction or Removal
20500 Injection of sinus tract, therapeutic (separate procedure)
20501 diagnostic (sinogram)
(for radiological supervision and interpretation, use 76080)
20520 Removal of foreign body in muscle or tendon sheath, simple
20525 deep or complicated
20526 Injection, therapeutic (eg, local anesthetic, corticosteriod) carpal tunnel
20550 Injections(s), single tendon sheath or ligament, aponeurosis (eg, plantar fascia)
20551 single tendon origin or insertion
20552 Injection: single or multiple trigger point(s), one or two muscles
20553 single or multiple triggter point(s), three or more muscles(s)
20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (fingers/toes)
20605 intermediate joint or bursa (AC, wrist, elbow, ankle, olecranon bursa)
20610 major joint or borsa (eg. shoulder, hip, knee, subacromial bursa)
20612 Aspiration and/or injection ganglion cyst(s) any location
(to report multiple ganglion cyst aspirations/injections, use 20612 with -59 modifier)
20650 Insertion of wire or pin with application of skeletal traction, including removal (separate procedure)
20660 Application of cranial tongs
20661 Application of halo, including removal, cranial
20662 pelvic
20663 femoral
20664 Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta), requiring general anesthesia
20665 Removal of tongs or halo applied by another physician
20670 Removal of implant; superficial, (eg, buried wire, pin or rod) (separate procedure) removal hardware
20680 Removal of implant; deep, (eg, buried wire, pin, screw, metal band, nail, rod or plate) removal of hardware
20690 Application of a uniplane (pins or wires in one plane), unilateral, external fixation system
20692 Application of a multiplane (pins or wires in more than one plane), unilateral, external fixation system (eg, Ilizarov, Monticelli type)
20693 Adjustment or revision of external fixation system requiring anesthesia (eg, new pin(s) or wire(s) and/or new ring(s) or bar(s))
20694 Removal, under anesthesia, of external fixation system
20974 Application of bone growth stimulator
(for Exogen, use E0760)
Rib Fracture
21800 Closed treatment, rib fracture
37202 Insertion of pain pump cath (PPO)
11981 insertion non-biodegradable drug delivery implant (Medicare)
11982 removal non-biodegradable drug delivery implant (any insur)
11983 removal with reinsertion, non-biodegradable drug delivery implant
