LCD/NCD Portal
Automated World Health
L28774
WOUND DEBRIDEMENT SERVICES
01/01/2011
Indications and Limitations of Coverage and/or Medical Necessity
Medicare will consider debridement services medically reasonable and necessary when they are provided for the management of wounds and ulcers of the skin and underlying tissue to promote optimal wound healing or to prepare sites for appropriate surgical intervention.
• The requirements for reasonable and necessary service(s) include safe and effective debridement methods most appropriate to the type of wound, furnished in the appropriate setting, and ordered and/or performed by qualified personnel.
• Skin Debridement (CPT codes 11000-11001)
o CPT codes 11000 and 11001 describe removal of extensive eczematous or infected skin.
Conditions that may require debridement of large amounts of skin include:
• Rapidly spreading necrotizing process (sometimes seen with aggressive streptococcal infections).
• Severe eczema.
• Bullous skin diseases.
• Extensive skin trauma (including large abraded areas with ground-in dirt).
• Autoimmune skin diseases (such as pemphigus).
o CPT code 11001 is NOT appropriate for debridement of a localized amount of tissue normally associated with a circumscribed lesion.
Examples of this are:
• Ulcers.
• Furnucles.
• Localized skin infections.
• Debridement of Necrotizing Soft Tissue Infections (CPT codes 11004-11008)
o CPT codes 11004-11006 describe extensive debridement of:
Skin.
Subcutaneous tissue.
Muscle.
Fascia to treat necrotizing soft tissue infections.
• Generally, these debridement procedures are performed on high-risk patients.
• The code descriptor indicates the specific area that receives treatment.
o CPT code 11008 describes the concurrent removal of a mesh or prosthetic device.
• Surgical Debridement (CPT codes 11042-11047)
o Surgical debridement occurs only if material has been excised and is typically reported for the treatment of a wound to clear and maintain the site free of devitalized tissue including necrosis, eschar, slough, infected tissue, abnormal granulation tissue etc., to the margins of viable tissue.
Surgical excision includes going slightly beyond the point of visible necrotic tissue until viable bleeding tissue is encountered in some cases.
The use of a sharp surgical instrument does not necessarily substantiate the performance of surgical excisional debridement.
Unless the medical record shows that a surgical excision debridement has been performed, debridements should be coded with either selective or non-selective codes (97597, 97598, or 97602).]
o Surgical debridement codes (11042-11047), as performed by physicians and qualified non-physician practitioners licensed by the state to perform those services, are reported by depth of tissue removed and by surface area of the wound.
These codes can be very effective but represent extensive debridement, often painful to the patient, and could require complex, surgical procedures and sometimes require the use of general anesthesia.
Surgical debridement will be considered as “not medically necessary” when documentation indicates the wound is without infection, necrosis, or nonviable tissues and has pink to red granulated tissue.
o Documentation for surgical debridement procedures should include the indications for the procedure, the type of anesthesia if and when used, and the narrative of the procedure that describes the wounds, as well as the details of the debridement procedure itself.
The CPT code selected should reflect the
• Level of debrided tissue.
o Skin
o Subcutaneous tissue.
o Muscle.
o Bone.
• NOT the extent, depth, of:
o Skin.
o Subcutaneous tissue.
o Muscle.
o Bone.
• Grade of the ulcer or wound.
For example, CPT code 11042 defined as “Debridement; subcutaneous tissue” should be used if only necrotic subcutaneous tissue is debrided, even though the ulcer or wound might extend to the bone.
• In addition, if only fibrin is removed, this code would not be billed.
o It would not be expected that an individual wound would be repeatedly debrided of skin and subcutaneous tissue because these tissues do not regrow very quickly.
• Active Wound Care Management
o Debridement is indicated whenever necrotic tissue is present on an open wound.
o Debridement may also be indicated in cases of abnormal wound healing or repair.
o Debridement will not be considered a reasonable and necessary procedure for a wound that is clean and free of necrotic tissue.
o This procedure includes wound assessment; debridement; application of ointments, creams, sealants, and other wound coverings; and instructions for ongoing care.
o It should be billed no more than once per day, regardless of the number of wounds.
• Selective Debridement (97597 and 97598)
o CPT codes 97597 and 97598 are used for the removal of specific, targeted areas of devitalized or necrotic tissue from a wound along the margin of viable tissue.
o Occasional bleeding and pain may occur.
o The routine application of a topical or local anesthetic does not elevate active wound care management to surgical debridement.
o Selective debridement includes:
Selective removal of necrotic tissue by sharp dissection including scissors, scalpel, and forceps.
Selective removal of necrotic tissue by high pressure water jet.
• Medicare coverage for wound care on a continuing basis for a given wound in a given patient is contingent upon evidence documented in the patient’s medical record that the wound is improving in response to the wound care being provided.
o It is neither reasonable nor medically necessary to continue a given type of wound care if evidence of wound improvement cannot be shown.
• Evidence of improvement includes, but is not limited to, measurable changes in at least some of the following:
o Drainage (color, amount, consistency).
o Inflammation.
o Swelling.
o Pain.
o Wound dimensions (diameter, depth, tunneling).
o Granulation tissue.
o Necrotic tissue/slough.
• Such evidence must be documented with each visit.
o A wound that shows no improvement after 30 days requires a new approach, which may include a
reassessment, by a qualified professional, of:
• Underlying infection problems inhibiting wound healing.
• Metabolic problems inhibiting wound healing.
• Nutritional problems inhibiting wound healing.
• Vascular problems inhibiting wound healing.
Or
New plan of care or treatment method.
• In rare instances, the goal of wound care provided in the outpatient setting may only be to prevent progression of the wound, which due to severe underlying debility or other factors such as inoperability, is not expected to improve.
LIMITATIONS
FCSO Medicare does NOT consider the following services to be wound debridement:
• Removal of necrotic tissue by cleansing, scraping (other than by a scalpel or a curette), chemical application, and wet-to-dry dressing.
• Washing bacterial or fungal debris from lesions.
• Removal of secretions and coagulation serum from normal skin surrounding an ulcer.
• Dressing of small or superficial lesions.
• Removal of fibrinous material from the margin of an ulcer.
• Paring or cutting of corns or non-plantar calluses.
o Skin breakdown under a dorsal corn that begins to heal when the corn is removed and shoe pressure eliminated is not considered an ulcer and does not require debridement unless there is extension into the subcutaneous tissue.
• Incision and drainage of abscess including paronychia, trimming or debridement of mycotic nails, avulsion of nail plates, acne surgery, or destruction of warts.
o Providers should report these procedures, when they represent covered, reasonable and necessary services, using appropriate CPT or HCPCS codes.
Coding Information
Bill Type Codes
• Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service.
• Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type.
• Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
12x Hospital Inpatient (Medicare Part B only)
13x Hospital Outpatient
22x Skilled Nursing - Inpatient (Medicare Part B only)
23x Skilled Nursing - Outpatient
71x Clinic - Rural Health
74x Clinic - Outpatient Rehabilitation Facility (ORF)
75x Clinic - Comprehensive Outpatient Rehabilitation Facility (CORF)
85x Critical Access Hospital
Revenue Codes
• Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service.
• In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination.
• Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.
0360 Operating Room Services - General Classification
0361 Operating Room Services - Minor Surgery
0420 Physical Therapy - General Classification
0421 Physical Therapy - Visit
0422 Physical Therapy - Hourly
0423 Physical Therapy - Group
0424 Physical Therapy - Evaluation or Re-evaluation
0429 Physical Therapy - Other Physical Therapy
0430 Occupational Therapy - General Classification
0431 Occupational Therapy - Visit
0432 Occupational Therapy - Hourly
0433 Occupational Therapy - Group
0434 Occupational Therapy - Evaluation or Reevaluation
0439 Occupational Therapy - Other Occupational Therapy
0450 Emergency Room - General Classification
0451 Emergency Room - EMTALA Emergency Medical Screening
0452 Emergency Room - ER Beyond EMTALA
0456 Emergency Room - Urgent Care
0459 Emergency Room - Other Emergency Room
0490 Ambulatory Surgical Care - General Classification
0499 Ambulatory Surgical Care - Other Ambulatory Surgical
0510 Clinic - General Classification
0511 Clinic - Chronic Pain Center
0512 Clinic - Dental Clinic
0513 Clinic - Psychiatric Clinic
0514 Clinic - OB-GYN Clinic
0515 Clinic - Pediatric Clinic
0516 Clinic - Urgent Care Clinic
0517 Clinic - Family Practice Clinic
0519 Clinic - Other Clinic
0520 Free-Standing Clinic - General Classification
0521 Free-Standing Clinic - Clinic Visit by Member to RHC/FQHC
0522 Free-Standing Clinic - Home Visit by RHC/FQHC Practitioner
0523 Free-Standing Clinic - Family Practice Clinic
0524 Free-Standing Clinic - Visit by RHC/FQHC Practitioner to a Member in a Covered Part A Stay at SNF
0525 Free-Standing Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF (not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility
0526 Free-Standing Clinic - Urgent Care Clinic
0527 Free-Standing Clinic - Visiting Nurse Service(s) to a Member's Home when in a Home Health Shortage Area
0528 Free-Standing Clinic - Visit by RHC/FQHC Practitioner to Other non-RHC/FQHC site (e.g., Scene of Accident)
0529 Free-Standing Clinic - Other Freestanding Clinic
0761 Specialty Services - Treatment Room
CPT/HCPCS Codes
11000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE
11001 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
11004 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING SOFT TISSUE INFECTION; EXTERNAL GENITALIA AND PERINEUM
11005 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING SOFT TISSUE INFECTION; ABDOMINAL WALL, WITH OR WITHOUT FASCIAL CLOSURE
11006 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING SOFT TISSUE INFECTION; EXTERNAL GENITALIA, PERINEUM AND ABDOMINAL WALL, WITH OR WITHOUT FASCIAL CLOSURE
11008 REMOVAL OF PROSTHETIC MATERIAL OR MESH, ABDOMINAL WALL FOR INFECTION (EG, FOR CHRONIC OR RECURRENT MESH INFECTION OR NECROTIZING SOFT TISSUE INFECTION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
11042 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS
11043 DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS
11044 DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS
11045 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
11046 DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
11047 DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
97597 DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS
97598 DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
ICD-9 Codes that Support Medical Necessity
040.0 GAS GANGRENE
110.0 DERMATOPHYTOSIS OF SCALP AND BEARD
110.1 DERMATOPHYTOSIS OF NAIL
110.2 DERMATOPHYTOSIS OF HAND
110.3 DERMATOPHYTOSIS OF GROIN AND PERIANAL AREA
110.4 DERMATOPHYTOSIS OF FOOT
110.5 DERMATOPHYTOSIS OF THE BODY
110.6 DEEP SEATED DERMATOPHYTOSIS
110.8 DERMATOPHYTOSIS OF OTHER SPECIFIED SITES
110.9 DERMATOPHYTOSIS OF UNSPECIFIED SITE
440.23 ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES WITH ULCERATION
440.24 ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES WITH GANGRENE
443.9 PERIPHERAL VASCULAR DISEASE UNSPECIFIED
454.0 VARICOSE VEINS OF LOWER EXTREMITIES WITH ULCER
454.2 VARICOSE VEINS OF LOWER EXTREMITIES WITH ULCER AND INFLAMMATION
569.41 ULCER OF ANUS AND RECTUM
608.4 OTHER INFLAMMATORY DISORDERS OF MALE GENITAL ORGANS
608.83 VASCULAR DISORDERS OF MALE GENITAL ORGANS
681.00 UNSPECIFIED CELLULITIS AND ABSCESS OF FINGER
681.01 FELON
681.02 ONYCHIA AND PARONYCHIA OF FINGER
681.10 UNSPECIFIED CELLULITIS AND ABSCESS OF TOE
681.11 ONYCHIA AND PARONYCHIA OF TOE
681.9 CELLULITIS AND ABSCESS OF UNSPECIFIED DIGIT
682.0 CELLULITIS AND ABSCESS OF FACE
682.1 CELLULITIS AND ABSCESS OF NECK
682.2 CELLULITIS AND ABSCESS OF TRUNK
682.3 CELLULITIS AND ABSCESS OF UPPER ARM AND FOREARM
682.4 CELLULITIS AND ABSCESS OF HAND EXCEPT FINGERS AND THUMB
682.5 CELLULITIS AND ABSCESS OF BUTTOCK
682.6 CELLULITIS AND ABSCESS OF LEG EXCEPT FOOT
682.7 CELLULITIS AND ABSCESS OF FOOT EXCEPT TOES
682.8 CELLULITIS AND ABSCESS OF OTHER SPECIFIED SITES
682.9 CELLULITIS AND ABSCESS OF UNSPECIFIED SITES
684 IMPETIGO
686.00 PYODERMA UNSPECIFIED
686.01 PYODERMA GANGRENOSUM
686.09 OTHER PYODERMA
686.1 PYOGENIC GRANULOMA OF SKIN AND SUBCUTANEOUS TISSUE
686.8 OTHER SPECIFIED LOCAL INFECTIONS OF SKIN AND SUBCUTANEOUS TISSUE
686.9 UNSPECIFIED LOCAL INFECTION OF SKIN AND SUBCUTANEOUS TISSUE
692.0 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO DETERGENTS
692.1 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO OILS AND GREASES
692.2 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO SOLVENTS
692.3 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO DRUGS AND MEDICINES IN CONTACT WITH SKIN
692.4 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO OTHER CHEMICAL PRODUCTS
692.5 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO FOOD IN CONTACT WITH SKIN
692.6 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO PLANTS (EXCEPT FOOD)
692.81 DERMATITIS DUE TO COSMETICS
692.82 DERMATITIS DUE TO OTHER RADIATION
692.83 DERMATITIS DUE TO METALS
692.84 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO ANIMAL (CAT) (DOG) DANDER
692.89 CONTACT DERMATITIS AND OTHER ECZEMA DUE TO OTHER SPECIFIED AGENTS
692.9 CONTACT DERMATITIS AND OTHER ECZEMA UNSPECIFIED CAUSE
707.00 PRESSURE ULCER, UNSPECIFIED SITE
707.01 PRESSURE ULCER, ELBOW
707.02 PRESSURE ULCER, UPPER BACK
707.03 PRESSURE ULCER, LOWER BACK
707.04 PRESSURE ULCER, HIP
707.05 PRESSURE ULCER, BUTTOCK
707.06 PRESSURE ULCER, ANKLE
707.07 PRESSURE ULCER, HEEL
707.09 PRESSURE ULCER, OTHER SITE
707.10 UNSPECIFIED ULCER OF LOWER LIMB
707.11 ULCER OF THIGH
707.12 ULCER OF CALF
707.13 ULCER OF ANKLE
707.14 ULCER OF HEEL AND MIDFOOT
707.15 ULCER OF OTHER PART OF FOOT
707.19 ULCER OF OTHER PART OF LOWER LIMB
707.20 PRESSURE ULCER, UNSPECIFIED STAGE
707.21 PRESSURE ULCER, STAGE I
707.22 PRESSURE ULCER, STAGE II
707.23 PRESSURE ULCER, STAGE III
707.24 PRESSURE ULCER, STAGE IV
707.25 PRESSURE ULCER, UNSTAGEABLE
707.8 CHRONIC ULCER OF OTHER SPECIFIED SITES
707.9 CHRONIC ULCER OF UNSPECIFIED SITE
709.4 FOREIGN BODY GRANULOMA OF SKIN AND SUBCUTANEOUS TISSUE
709.8 OTHER SPECIFIED DISORDERS OF SKIN
728.86 NECROTIZING FASCIITIS
730.10 CHRONIC OSTEOMYELITIS SITE UNSPECIFIED
730.11 CHRONIC OSTEOMYELITIS INVOLVING SHOULDER REGION
730.12 CHRONIC OSTEOMYELITIS INVOLVING UPPER ARM
730.13 CHRONIC OSTEOMYELITIS INVOLVING FOREARM
730.14 CHRONIC OSTEOMYELITIS INVOLVING HAND
730.15 CHRONIC OSTEOMYELITIS INVOLVING PELVIC REGION AND THIGH
730.16 CHRONIC OSTEOMYELITIS INVOLVING LOWER LEG
730.17 CHRONIC OSTEOMYELITIS INVOLVING ANKLE AND FOOT
730.18 CHRONIC OSTEOMYELITIS INVOLVING OTHER SPECIFIED SITES
730.19 CHRONIC OSTEOMYELITIS INVOLVING MULTIPLE SITES
785.4 GANGRENE
870.0 LACERATION OF SKIN OF EYELID AND PERIOCULAR AREA
870.1 LACERATION OF EYELID FULL-THICKNESS NOT INVOLVING LACRIMAL PASSAGES
870.2 LACERATION OF EYELID INVOLVING LACRIMAL PASSAGES
872.00 OPEN WOUND OF EXTERNAL EAR UNSPECIFIED SITE UNCOMPLICATED
872.01 OPEN WOUND OF AURICLE UNCOMPLICATED
872.02 OPEN WOUND OF AUDITORY CANAL UNCOMPLICATED
872.10 OPEN WOUND OF EXTERNAL EAR UNSPECIFIED SITE COMPLICATED
872.11 OPEN WOUND OF AURICLE COMPLICATED
872.12 OPEN WOUND OF AUDITORY CANAL COMPLICATED
873.0 OPEN WOUND OF SCALP WITHOUT COMPLICATION
873.1 OPEN WOUND OF SCALP COMPLICATED
873.20 OPEN WOUND OF NOSE UNSPECIFIED SITE UNCOMPLICATED
873.21 OPEN WOUND OF NASAL SEPTUM UNCOMPLICATED
873.22 OPEN WOUND OF NASAL CAVITY UNCOMPLICATED
873.23 OPEN WOUND OF NASAL SINUS UNCOMPLICATED
873.29 OPEN WOUND OF MULTIPLE SITES UNCOMPLICATED
873.30 OPEN WOUND OF NOSE UNSPECIFIED SITE COMPLICATED
873.31 OPEN WOUND OF NASAL SEPTUM COMPLICATED
873.32 OPEN WOUND OF NASAL CAVITY COMPLICATED
873.33 OPEN WOUND OF NASAL SINUS COMPLICATED
873.39 OPEN WOUND OF MULTIPLE SITES COMPLICATED
873.40 OPEN WOUND OF FACE UNSPECIFIED SITE UNCOMPLICATED
873.41 OPEN WOUND OF CHEEK UNCOMPLICATED
873.42 OPEN WOUND OF FOREHEAD UNCOMPLICATED
873.43 OPEN WOUND OF LIP UNCOMPLICATED
873.44 OPEN WOUND OF JAW UNCOMPLICATED
873.49 OPEN WOUND OF OTHER AND MULTIPLE SITES UNCOMPLICATED
873.50 OPEN WOUND OF FACE UNSPECIFIED SITE COMPLICATED
873.51 OPEN WOUND OF CHEEK COMPLICATED
873.52 OPEN WOUND OF FOREHEAD COMPLICATED
873.53 OPEN WOUND OF LIP COMPLICATED
873.54 OPEN WOUND OF JAW COMPLICATED
873.59 OPEN WOUND OF OTHER AND MULTIPLE SITES COMPLICATED
873.60 OPEN WOUND OF MOUTH UNSPECIFIED SITE UNCOMPLICATED
873.61 OPEN WOUND OF BUCCAL MUCOSA UNCOMPLICATED
873.70 OPEN WOUND OF MOUTH UNSPECIFIED SITE COMPLICATED
873.71 OPEN WOUND OF BUCCAL MUCOSA COMPLICATED
873.72 OPEN WOUND OF GUM (ALVEOLAR PROCESS) COMPLICATED
873.74 OPEN WOUND OF TONGUE AND FLOOR OF MOUTH COMPLICATED
873.75 OPEN WOUND OF PALATE COMPLICATED
873.79 OPEN WOUND OF OTHER AND MULTIPLE SITES COMPLICATED
873.8 OTHER AND UNSPECIFIED OPEN WOUND OF HEAD WITHOUT COMPLICATION
873.9 OTHER AND UNSPECIFIED OPEN WOUND OF HEAD COMPLICATED
874.00 OPEN WOUND OF LARYNX WITH TRACHEA UNCOMPLICATED
874.01 OPEN WOUND OF LARYNX UNCOMPLICATED
874.02 OPEN WOUND OF TRACHEA UNCOMPLICATED
874.10 OPEN WOUND OF LARYNX WITH TRACHEA COMPLICATED
874.11 OPEN WOUND OF LARYNX COMPLICATED
874.12 OPEN WOUND OF TRACHEA COMPLICATED
874.2 OPEN WOUND OF THYROID GLAND WITHOUT COMPLICATION
874.3 OPEN WOUND OF THYROID GLAND COMPLICATED
874.4 OPEN WOUND OF PHARYNX WITHOUT COMPLICATION
874.5 OPEN WOUND OF PHARYNX COMPLICATED
874.8 OPEN WOUND OF OTHER AND UNSPECIFIED PARTS OF NECK WITHOUT COMPLICATION
874.9 OPEN WOUND OF OTHER AND UNSPECIFIED PARTS OF NECK COMPLICATED
875.0 OPEN WOUND OF CHEST (WALL) WITHOUT COMPLICATION
875.1 OPEN WOUND OF CHEST (WALL) COMPLICATED
876.0 OPEN WOUND OF BACK WITHOUT COMPLICATION
876.1 OPEN WOUND OF BACK COMPLICATED
877.0 OPEN WOUND OF BUTTOCK WITHOUT COMPLICATION
877.1 OPEN WOUND OF BUTTOCK COMPLICATED
878.0 OPEN WOUND OF PENIS WITHOUT COMPLICATION
878.1 OPEN WOUND OF PENIS COMPLICATED
878.2 OPEN WOUND OF SCROTUM AND TESTES WITHOUT COMPLICATION
878.3 OPEN WOUND OF SCROTUM AND TESTES COMPLICATED
878.4 OPEN WOUND OF VULVA WITHOUT COMPLICATION
878.5 OPEN WOUND OF VULVA COMPLICATED
878.6 OPEN WOUND OF VAGINA WITHOUT COMPLICATION
878.7 OPEN WOUND OF VAGINA COMPLICATED
878.8 OPEN WOUND OF OTHER AND UNSPECIFIED PARTS OF GENITAL ORGANS WITHOUT COMPLICATION
878.9 OPEN WOUND OF OTHER AND UNSPECIFIED PARTS OF GENITAL ORGANS COMPLICATED
879.0 OPEN WOUND OF BREAST WITHOUT COMPLICATION
879.1 OPEN WOUND OF BREAST COMPLICATED
879.2 OPEN WOUND OF ABDOMINAL WALL ANTERIOR WITHOUT COMPLICATION
879.3 OPEN WOUND OF ABDOMINAL WALL ANTERIOR COMPLICATED
879.4 OPEN WOUND OF ABDOMINAL WALL LATERAL WITHOUT COMPLICATION
879.5 OPEN WOUND OF ABDOMINAL WALL LATERAL COMPLICATED
879.6 OPEN WOUND OF OTHER AND UNSPECIFIED PARTS OF TRUNK WITHOUT COMPLICATION
879.7 OPEN WOUND OF OTHER AND UNSPECIFIED PARTS OF TRUNK COMPLICATED
879.8 OPEN WOUND(S) (MULTIPLE) OF UNSPECIFIED SITE(S) WITHOUT COMPLICATION
879.9 OPEN WOUND(S) (MULTIPLE) OF UNSPECIFIED SITE(S) COMPLICATED
880.00 OPEN WOUND OF SHOULDER REGION WITHOUT COMPLICATION
880.01 OPEN WOUND OF SCAPULAR REGION WITHOUT COMPLICATION
880.02 OPEN WOUND OF AXILLARY REGION WITHOUT COMPLICATION
880.03 OPEN WOUND OF UPPER ARM WITHOUT COMPLICATION
880.09 OPEN WOUND OF MULTIPLE SITES OF SHOULDER AND UPPER ARM WITHOUT COMPLICATION
880.10 OPEN WOUND OF SHOULDER REGION COMPLICATED
880.11 OPEN WOUND OF SCAPULAR REGION COMPLICATED
880.12 OPEN WOUND OF AXILLARY REGION COMPLICATED
880.13 OPEN WOUND OF UPPER ARM COMPLICATED
880.19 OPEN WOUND OF MULTIPLE SITES OF SHOULDER AND UPPER ARM COMPLICATED
880.20 OPEN WOUND OF SHOULDER REGION WITH TENDON INVOLVEMENT
880.21 OPEN WOUND OF SCAPULAR REGION WITH TENDON INVOLVEMENT
880.22 OPEN WOUND OF AXILLARY REGION WITH TENDON INVOLVEMENT
880.23 OPEN WOUND OF UPPER ARM WITH TENDON INVOLVEMENT
880.29 OPEN WOUND OF MULTIPLE SITES OF SHOULDER AND UPPER ARM WITH TENDON INVOLVEMENT
881.00 OPEN WOUND OF FOREARM WITHOUT COMPLICATION
881.01 OPEN WOUND OF ELBOW WITHOUT COMPLICATION
881.02 OPEN WOUND OF WRIST WITHOUT COMPLICATION
881.10 OPEN WOUND OF FOREARM COMPLICATED
881.11 OPEN WOUND OF ELBOW COMPLICATED
881.12 OPEN WOUND OF WRIST COMPLICATED
881.20 OPEN WOUND OF FOREARM WITH TENDON INVOLVEMENT
881.21 OPEN WOUND OF ELBOW WITH TENDON INVOLVEMENT
881.22 OPEN WOUND OF WRIST WITH TENDON INVOLVEMENT
882.0 OPEN WOUND OF HAND EXCEPT FINGERS ALONE WITHOUT COMPLICATION
882.1 OPEN WOUND OF HAND EXCEPT FINGERS ALONE COMPLICATED
882.2 OPEN WOUND OF HAND EXCEPT FINGERS ALONE WITH TENDON INVOLVEMENT
883.0 OPEN WOUND OF FINGERS WITHOUT COMPLICATION
883.1 OPEN WOUND OF FINGERS COMPLICATED
883.2 OPEN WOUND OF FINGERS WITH TENDON INVOLVEMENT
884.0 MULTIPLE AND UNSPECIFIED OPEN WOUND OF UPPER LIMB WITHOUT COMPLICATION
884.1 MULTIPLE AND UNSPECIFIED OPEN WOUND OF UPPER LIMB COMPLICATED
884.2 MULTIPLE AND UNSPECIFIED OPEN WOUND OF UPPER LIMB WITH TENDON INVOLVEMENT
885.0 TRAUMATIC AMPUTATION OF THUMB (COMPLETE)(PARTIAL) WITHOUT COMPLICATION
885.1 TRAUMATIC AMPUTATION OF THUMB (COMPLETE)(PARTIAL) COMPLICATED
886.0 TRAUMATIC AMPUTATION OF OTHER FINGER(S) (COMPLETE) (PARTIAL) WITHOUT COMPLICATION
886.1 TRAUMATIC AMPUTATION OF OTHER FINGER(S) (COMPLETE) (PARTIAL) COMPLICATED
887.0 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) UNILATERAL BELOW ELBOW WITHOUT COMPLICATION
887.1 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) UNILATERAL BELOW ELBOW COMPLICATED
887.2 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) UNILATERAL AT OR ABOVE ELBOW WITHOUT COMPLICATION
887.3 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) UNILATERAL AT OR ABOVE ELBOW COMPLICATED
887.4 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) UNILATERAL LEVEL NOT SPECIFIED WITHOUT COMPLICATION
887.5 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) UNILATERAL LEVEL NOT SPECIFIED COMPLICATED
887.6 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) BILATERAL (ANY LEVEL) WITHOUT COMPLICATION
887.7 TRAUMATIC AMPUTATION OF ARM AND HAND (COMPLETE) (PARTIAL) BILATERAL (ANY LEVEL) COMPLICATED
890.0 OPEN WOUND OF HIP AND THIGH WITHOUT COMPLICATION
890.1 OPEN WOUND OF HIP AND THIGH COMPLICATED
890.2 OPEN WOUND OF HIP AND THIGH WITH TENDON INVOLVEMENT
891.0 OPEN WOUND OF KNEE LEG (EXCEPT THIGH) AND ANKLE WITHOUT COMPLICATION
891.1 OPEN WOUND OF KNEE LEG (EXCEPT THIGH) AND ANKLE COMPLICATED
891.2 OPEN WOUND OF KNEE LEG (EXCEPT THIGH) AND ANKLE WITH TENDON INVOLVEMENT
892.0 OPEN WOUND OF FOOT EXCEPT TOE(S) ALONE WITHOUT COMPLICATION
892.1 OPEN WOUND OF FOOT EXCEPT TOE(S) ALONE COMPLICATED
892.2 OPEN WOUND OF FOOT EXCEPT TOE(S) ALONE WITH TENDON INVOLVEMENT
893.0 OPEN WOUND OF TOE(S) WITHOUT COMPLICATION
893.1 OPEN WOUND OF TOE(S) COMPLICATED
893.2 OPEN WOUND OF TOE(S) WITH TENDON INVOLVEMENT
895.0 TRAUMATIC AMPUTATION OF TOE(S) (COMPLETE) (PARTIAL) WITHOUT COMPLICATION
895.1 TRAUMATIC AMPUTATION OF TOE(S) (COMPLETE) (PARTIAL) COMPLICATED
896.0 TRAUMATIC AMPUTATION OF FOOT (COMPLETE) (PARTIAL) UNILATERAL WITHOUT COMPLICATION
896.1 TRAUMATIC AMPUTATION OF FOOT (COMPLETE) (PARTIAL) UNILATERAL COMPLICATED
896.2 TRAUMATIC AMPUTATION OF FOOT (COMPLETE) (PARTIAL) BILATERAL WITHOUT COMPLICATION
896.3 TRAUMATIC AMPUTATION OF FOOT (COMPLETE) (PARTIAL) BILATERAL COMPLICATED
897.0 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) UNILATERAL BELOW KNEE WITHOUT COMPLICATION
897.1 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) UNILATERAL BELOW KNEE COMPLICATED
897.2 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) UNILATERAL AT OR ABOVE KNEE WITHOUT COMPLICATION
897.3 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) UNILATERAL AT OR ABOVE KNEE COMPLICATED
897.4 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) UNILATERAL LEVEL NOT SPECIFIED WITHOUT COMPLICATION
897.5 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) UNILATERAL LEVEL NOT SPECIFIED COMPLICATED
897.6 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) BILATERAL (ANY LEVEL) WITHOUT COMPLICATION
897.7 TRAUMATIC AMPUTATION OF LEG(S) (COMPLETE) (PARTIAL) BILATERAL (ANY LEVEL) COMPLICATED
941.20 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF FACE AND HEAD UNSPECIFIED SITE
941.21 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF EAR (ANY PART)
941.22 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF EYE (WITH OTHER PARTS OF FACE HEAD AND NECK)
941.23 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF LIP(S)
941.24 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF CHIN
941.25 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF NOSE (SEPTUM)
941.26 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF SCALP (ANY PART)
941.27 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF FOREHEAD AND CHEEK
941.28 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF NECK
941.29* BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES (EXCEPT WITH EYE) OF FACE HEAD AND NECK
941.30 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF FACE AND HEAD
941.31 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF EAR (ANY PART)
941.32 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF EYE (WITH OTHER PARTS OF FACE HEAD AND NECK)
941.33 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF LIP(S)
941.34 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF CHIN
941.35 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF NOSE (SEPTUM)
941.36 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF SCALP (ANY PART)
941.37 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF FOREHEAD AND CHEEK
941.38 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF NECK
941.39* FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES (EXCEPT WITH EYE) OF FACE HEAD AND NECK
941.40 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF FACE AND HEAD WITHOUT LOSS OF BODY PART
941.41 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF EAR (ANY PART) WITHOUT LOSS OF EAR
941.42 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF EYE (WITH OTHER PARTS OF FACE HEAD AND NECK) WITHOUT LOSS OF BODY PART
941.43 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF LIP(S) WITHOUT LOSS OF LIP(S)
941.44 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF CHIN WITHOUT LOSS OF CHIN
941.45 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF NOSE (SEPTUM) WITHOUT LOSS OF NOSE
941.46 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF SCALP (ANY PART) WITHOUT LOSS OF SCALP
941.47 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF FOREHEAD AND CHEEK WITHOUT LOSS OF FOREHEAD AND CHEEK
941.48 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF NECK WITHOUT LOSS OF NECK
941.49* DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES (EXCEPT WITH EYE) OF FACE HEAD AND NECK WITHOUT LOSS OF A BODY PART
942.20 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF UNSPECIFIED SITE OF TRUNK
942.21 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF BREAST
942.22 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF CHEST WALL EXCLUDING BREAST AND NIPPLE
942.23 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF ABDOMINAL WALL
942.24 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF BACK (ANY PART)
942.25 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF GENITALIA
942.29* BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF OTHER AND MULTIPLE SITES OF TRUNK
942.30 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF TRUNK
942.31 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF BREAST
942.32 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF CHEST WALL EXCLUDING BREAST AND NIPPLE
942.33 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF ABDOMINAL WALL
942.34 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF BACK (ANY PART)
942.35 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF GENITALIA
942.39* FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF OTHER AND MULTIPLE SITES OF TRUNK
942.40 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF TRUNK UNSPECIFIED SITE WITHOUT LOSS OF BODY PART
942.41 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF BREAST WITHOUT LOSS OF BREAST
942.42 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF CHEST WALL EXCLUDING BREAST AND NIPPLE WITHOUT LOSS OF CHEST WALL
942.43 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF ABDOMINAL WALL WITHOUT LOSS OF ABDOMINAL WALL
942.44 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF BACK (ANY PART) WITHOUT LOSS OF BACK
942.45 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF GENITALIA WITHOUT LOSS OF GENITALIA
942.49* DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF OTHER AND MULTIPLE SITES OF TRUNK WITHOUT LOSS OF BODY PART
943.20 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF UNSPECIFIED SITE OF UPPER LIMB
943.21 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF FOREARM
943.22 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF ELBOW
943.23 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF UPPER ARM
943.24 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF AXILLA
943.25 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF SHOULDER
943.26 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF SCAPULAR REGION
943.29* BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND
943.30 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF UPPER LIMB
943.31 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF FOREARM
943.32 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF ELBOW
943.33 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UPPER ARM
943.34 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF AXILLA
943.35 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF SHOULDER
943.36 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF SCAPULAR REGION
943.39* FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND
943.40 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF UPPER LIMB WITHOUT LOSS OF A BODY PART
943.41 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF FOREARM WITHOUT LOSS OF FOREARM
943.42 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF ELBOW WITHOUT LOSS OF ELBOW
943.43 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UPPER ARM WITHOUT LOSS OF UPPER ARM
943.44 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN OF AXILLA WITHOUT LOSS OF AXILLA
943.45 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF SHOULDER WITHOUT LOSS OF SHOULDER
943.46 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF SCAPULAR REGION WITHOUT LOSS OF SCAPULA
943.49* DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND WITHOUT LOSS OF UPPER LIMB
944.20 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF UNSPECIFIED SITE OF HAND
944.21 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF SINGLE DIGIT (FINGER (NAIL)) OTHER THAN THUMB
944.22 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN OF (SECOND DEGREE) OF THUMB (NAIL)
944.23 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF TWO OR MORE DIGITS OF HAND NOT INCLUDING THUMB
944.24 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF TWO OR MORE DIGITS OF HAND INCLUDING THUMB
944.25 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF PALM OF HAND
944.26 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF BACK OF HAND
944.27 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF WRIST
944.28* BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES OF WRIST(S) AND HAND(S)
944.30 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF HAND
944.31 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF SINGLE DIGIT (FINGER (NAIL)) OTHER THAN THUMB
944.32 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF THUMB (NAIL)
944.33 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF TWO OR MORE DIGITS OF HAND NOT INCLUDING THUMB
944.34 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF TWO OR MORE DIGITS OF HAND INCLUDING THUMB
944.35 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF PALM OF HAND
944.36 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF BACK OF HAND
944.37 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF WRIST
944.38* FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES OF WRIST(S) AND HAND(S)
944.40 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF HAND WITHOUT LOSS OF HAND
944.41 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF SINGLE DIGIT (FINGER (NAIL)) OTHER THAN THUMB WITHOUT LOSS OF FINGER
944.42 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF THUMB (NAIL) WITHOUT LOSS OF THUMB
944.43 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF TWO OR MORE DIGITS OF HAND NOT INCLUDING THUMB WITHOUT FINGERS
944.44 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF TWO OR MORE DIGITS OF HAND INCLUDING THUMB WITHOUT LOSS OF FINGERS
944.45 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF PALM OF HAND WITHOUT LOSS OF PALM
944.46 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF BACK OF HAND WITHOUT LOSS OF BACK OF HAND
944.47 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF WRIST WITHOUT LOSS OF WRIST
944.48* DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF WRIST(S) AND HAND(S) WITHOUT LOSS OF A BODY PART
945.20 BLISTERS EPIDERMAL LOSS (SECOND DEGREE) OF UNSPECIFIED SITE OF LOWER LIMB (LEG)
945.21 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF TOE(S) (NAIL)
945.22 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF FOOT
945.23 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF ANKLE
945.24 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF LOWER LEG
945.25 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF KNEE
945.26 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF THIGH (ANY PART)
945.29* BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES OF LOWER LIMB(S)
945.30 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF LOWER LIMB
945.31 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF TOE(S) (NAIL)
945.32 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF FOOT
945.33 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF ANKLE
945.34 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF LOWER LEG
945.35 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF KNEE
945.36 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF THIGH (ANY PART)
945.39* FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES OF LOWER LIMB(S)
945.40 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF LOWER LIMB (LEG) WITHOUT LOSS OF A BODY PART
945.41 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF TOE(S) (NAIL) WITHOUT LOSS OF TOE(S)
945.42 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF FOOT WITHOUT LOSS OF FOOT
945.43 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF ANKLE WITHOUT LOSS OF ANKLE
945.44 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF LOWER LEG WITHOUT LOSS OF LOWER LEG
945.45 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF KNEE WITHOUT LOSS OF KNEE
945.46 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF THIGH (ANY PART) WITHOUT LOSS OF THIGH
945.49* DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF LOWER LIMB(S) WITHOUT LOSS OF A BODY PART
946.2* BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SPECIFIED SITES
946.3* FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SPECIFIED SITES
946.4* DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SPECIFIED SITES WITHOUT LOSS OF A BODY PART
958.3 POSTTRAUMATIC WOUND INFECTION NOT ELSEWHERE CLASSIFIED
997.60 UNSPECIFIED LATE COMPLICATION OF AMPUTATION STUMP
997.62 INFECTION (CHRONIC) OF AMPUTATION STUMP
998.30 DISRUPTION OF WOUND, UNSPECIFIED
998.31 DISRUPTION OF INTERNAL OPERATION (SURGICAL) WOUND
998.32 DISRUPTION OF EXTERNAL OPERATION (SURGICAL) WOUND
998.33 DISRUPTION OF TRAUMATIC INJURY WOUND REPAIR
998.59 OTHER POSTOPERATIVE INFECTION
998.83 NON-HEALING SURGICAL WOUND
* These additional ICD-9-CM codes are to be used with CPT codes 97597 and 97598 only.
Documentation Requirements
• Medical record documentation maintained by the performing provider must clearly indicate the medical necessity of the service being billed.
• The medical record must include the following information and be available to Medicare upon request:
o An operative note or procedure note for the debridement service(s).
o This note should describe the anatomical location treated, the instruments used, anesthesia used if required, the type of tissue removed from the wound, the depth and area of the wound and the immediate post-op care and follow-up instructions.
o Identification of the wound location, size, depth and stage by description and may include a drawing or photograph.
o A description of the type(s) of tissue involvement:
Severity of tissue destruction.
Undermining or tunneling.
Necrosis.
Infection.
Evidence of reduced circulation.
o A pathology report when billing for the debridement procedure described by CPT code 11044.
• In addition, except for patients with compromised healing due to severe underlying debility or other factors, documentation in the medical record must show:
o The status of the wound is such that the treatment is expected to make a significant practical improvement in the wound in a reasonable and generally predictable period of time.
o There is an expectation that the treatment will substantially affect tissue healing and viability, reduce or control tissue infection, remove necrotic tissue or prepare the tissue for surgical management.
o The patient’s expected restoration potential must be significant in relation to the extent and duration of treatment required [in] achieving this potential. If wound closure is not a goal, then the expectation is to optimize recovery and establish an appropriate non-skilled maintenance program.
• Active wound care management performed by a physical or occupational therapist must be performed under a certified plan of care as any other therapy service outlining:
o Specific goals.
o Duration.
o Frequency.
o Modalities.
o An anticipated endpoint.
o Other pertinent factors as they may apply.
o Departure from this plan must be documented.
Utilization Guidelines
• The appropriate interval and frequency of debridement depends on the individual clinical characteristics of patients and the extent of the wound.
o Reduction of pressure and/or control of infection will facilitate healing and may reduce the need for repeated debridement services.
o The treatment plan for a patient who requires frequent repeated debridement should be reevaluated to ensure that pressure reduction and infection control have been adequately addressed.
• Debridement services are not considered to be medically necessary when performed more frequently than once a week.
o The rationale and medical justification for more frequent services must be clearly documented in the medical record.
o If the debridement of chronic ulcers require more than EIGHT total services for any of the debridement codes listed in this LCD (CPT codes 11000-97598), the rationale and medical justification for this utilization, on a given day or over time, must be specifically addressed in the medical record.
Treatment Logic
• Debridement is the removal of infected, contaminated, damaged, devitalized, necrotic, or foreign tissue from a wound.
• Debridement promotes wound healing by reducing sources of infection and other mechanical impediments to healing.
Sources of Information and Basis for Decision
Ayello, E., & Cuddigan, J. (2004). Debridement: Controlling the necrotic/cellular burden. Advances in Skin & Wound Care, 17:66-78.
Black, J., Baharestani, M., Cuddigan, J., Dorner, B., Edsberg, L., Langemo, D., & et al. (2007). National pressure ulcer advisory panel’s updated pressure ulcer staging system. Dermatology Nursing. 19(4): 343-349.
Choucair, M. M., Fivenson, D. P. (2001). Leg ulcer diagnosis and management. Retrieved March 19, 2002 from http://homeconsult.com/das/article/body/1/jorg=journal&source=MI&sp=12040563&sid This reference provided information surrounding appropriate diagnoses criteria.
CPT Assistant – June 2005 & October 2007
CPT Changes: An Insider’s View – 2005, & 2008, 2011
Debridement. (2004). Body1, Inc. Retrieved October 6, 2008 from http://www.wounds1.com/care/procedure20.cfm/19
Deery, H. G., & Sangererozan, J. A. (2001). Saving the diabetic foot with special reference to the patient with chronic renal failure. Retrieved March 19, 2002 from http://home.mdconsult.com/das/article/body/1/jorg=journal&source=MI&sp=11974766&sid This reference provided definitions and indications for wound management.
FCSO LCD 29128, Wound Debridement Services, 01/01/2011. The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/.
Fife, C. (2008). The debridement predicament. Retrieved October 6, 2008 from: http://www.intellicure.com/News/2008_01-02_Pulse/debridement _predicament.htm
Lewis, R., Whiting, P., ter Riet, G., O’Meara S., & Glanville, J. (2001). A rapid and systemic review of the clinical effectiveness and cost-effectiveness of debriding agents in treating surgical wounds healing by secondary intention. Retrieved March 19, 2002 from http://home.mdconsult.com/das/citation/body/jorg=journal&source=MI&sp=11892394&sid This reference provided expectations of treatments for wounds.
Other Medicare Contractors’ LCDs.
Paquette, D., & Fatanga, V. (2002). Leg ulcers. Retrieved March 19, 2002 from http://home.mdconsult.com/das/article/body/1/jorg=journal&source=&sp=12074980&sid This reference provided descriptions and treatments for leg wounds.
Salcido, R., & Popescu, A. (2006). Pressure ulcers and wound care. Retrieved October 1, 2008 from : http://www.emedicine.com/pmr/TOPIC179.HTM
Schaum, K. (2006). Newly funded selective and non-selective debridement CPT codes: Impact on hospital-owned outpatient wound care departments. Healthpoint, Inc. Retrieved October 1, 2008 from: http://www.woundsresearch.com/docs/Healthpoint_August.pdf
Stillman, R. (2008). Diabetic ulcers. Retrieved October 2, 2008 from : http://www.emedicine.com/med/TOPIC551.HTM
Suzuki, K. & Cowan, L. (2009). Current concepts in wound debridement. Podiatry Today, 22(7) July 1.
Tatsioni, A., Balk, E., O’Donnell, T., Lau, J. (2007). Usual care in the management of chronic wounds: A review of the recent literature. Journal of the American College of Surgeons, 205(4).
Ulcer. (2008). New World Encyclopedia. Retrieved October 2, 2008 from http://www.newworldencyclopedia.org/entry/Ulcer?oldid=683900
Valencia, I., Falabella, A., Kirsner, R. S., & Eaglstein, W. E. (2001). Chronic venous insufficiency and venous leg ulceration. Retrieved March 19, 2002 from http:/home.mdconsult.com/das/article/body/1/jorg=journal&source=MI&sp=11546251&sid This reference defined and discussed debridement and other treatment modalities.
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CPT codes, descriptions and other data only are copyright 2011 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.
CMS LCD L28774 WOUND DEBRIDEMENT SERVICES