There are many coding guidelines found throughout the CPT coding manual. Each of the six sections has a specific set of guidelines that are for the entire section. Most of the guidelines are located within the individual subsections and relate to a specific smaller group of codes. As you work on assigning codes for services performed on the Integumentary system, reflect on the purpose and meaning of the guidelines found throughout this subsection. 

 

1. Describe one difference between coding guidelines for Debridement (11042-11047) and coding guidelines for Repair (12001-13160).
2. Summarize what the coding guidelines for Debridement (11042-11047) instruct the coder to do when assigning codes for these services.
3. Summarize what the coding guidelines for Repair (12001-13160) instruct the coder to do when assigning codes for these services.

1.) Describe one difference between coding guidelines for Debridement (11042-11047) and coding guidelines for Repair (12001-13160).

• Coding guidelines supply both coders and health care providers with the information required to properly document, assign codes, and report diagnoses and procedures.
• The difference between this guidelines is that they have different rules or guidelines on what codes to assign.

2.) Summarize what the coding guidelines for Debridement (11042-11047) instruct the coder to do when assigning codes for these services.

• Debridement of a wound, performed before the application of a topical or local anesthesia is billed with CPT codes 11042 - 11047. Wound debridements (11042-11047) are reported by depth of tissue that is removed and by surface area of the wound. When performing debridement of a single wound, report depth using the deepest level of tissue removed. In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths.
•  Do not report 11042 -11047 in conjunction with 97597-97602 for the same wound.
• CPT code 11043, 11046 and 11044, 11047 may only be billed in place of service inpatient hospital, outpatient hospital or ambulatory surgical center (ASC).
• CPT codes 11043, 11046 and 11044, 11047 are codes that describe deep debridement of the muscle and bone.

3.) Summarize what the coding guidelines for Repair (12001-13160) instruct the coder to do when assigning codes for these services.

• CPT® directs you to report Repair (Closure) codes 12001-13160, as appropriate to the type (simple, intermediate, or complex), location, and length of the wound "to designate wound closure utilizing sutures, staples or tissue adhesives (eg, 2-cyanoacrylate), either singly or in combination with each other, or in combination with adhesive strips."
• Private, third-party payers generally follow CPT® guidelines and allow you to report 12001-13160 for tissue adhesives, whether used alone or with other closure methods.
• However, If the provider uses only tissue adhesive to close the wound, you must report G0168 Wound closure utilizing tissue adhesive(s) only for Medicare payers.