Burn debridement and coding help!
Here is a message I got from a surgeon at our burn hospital : I always forget to whom I should address this issue, but I have been getting a number of inappropriate queries for burn patients. I keep getting queries when I excise a burn that inquire about the depth excised – as you would for an "excisional debridement" of a wound. This means that they are billing inappropriately. I also recently received a query about the depth of a burn – as to whether it was 2nd or 3rd degree, when it was clearly stated as partial thickness in multiple
Should you ever query for excisional debridement on burn patients or are they getting confused with CPT/profee billing rather than ICD-10? Any info or education on burn debridement would be much appreciated.
Comments
We don't see many burns but since no one has responded as of yet, I will take a stab.
1. as for the issue of querying on partial-thickness burns. 'Partial thickness' codes to an unspecified degree so they were probably providing an opportunity to provide additional specificity.
2. On the debridement. As far as I know there separate designation for the coding of a debridement due to a burn. The coder still has to determine the type (excisional vs nonexcisional) and the depth.
I am not well-versed in outpatient coding but I did take a look at my CPT book (I am looking at an old version so codes referenced may not be accurate) and it does appear that this is likely where the confusion is coming from. There is a separate category for burns (look up 16000) and for CPT there are codes (16020-16030) for dressings/debridement's of 'partial thickness' burns. No additional specificity is required as to excisional/nonexcisional and the depth in CPT. I am guessing this is where the issue is coming from.
I would advise providing some education that the documentation requirements for his personal coding versus the hospital are different. This information is essential for proper code selection.
Hope that helps
Katy Good