Excisional debridement specifics-inpatient

jadeed@unionhospital.org

Lately, some of our podiatrists have been writing selective debridement. The descriptions sound like they are excisional debridements, since they used words, such as "sharp", "devitalized tissue" removed, etc, but I guess I'm not all too familiar with the idea of selective debridement and when to query.I found the below article on selective debridement
Differentiate between types of wound debridement

JustCoding News: Outpatient, August 8, 2012

http://www.hcpro.com/HIM-283163-8160/Differentiate-between-types-of-wound-debridement.html

Excisional debridement is the sharp removal of tissue at the wound margin or at the wound base until viable tissue is removed

Selective debridement (CPT codes 97597-97598) is the removal of nonviable tissue. Unlike excisional debridement, the physician removes no living tissue in a selective debridement.

So I have been querying if they don't include verbiage on debridements, when they don't specify if they debride into healthy tissue, or if there is no similar wording message of debriding of the devitalized tissue to normal bleeding tissue.

 Am I being too particular ? If they sound like excisional debridement, and mention getting rid of devitalized tissue, but don't include that they debrided to normal healthy tissue, should I take the time to query?

Thank you in advance to anyone who would be able to help me.

jadeed@unionhospital.org

Does anyone have any input on this?

lprescott1

the link below offers some guidance. 

Differentiate between types of wound debridement

JustCoding News: Outpatient, August 8, 2012

http://www.hcpro.com/HIM-283163-8160/Differentiate-between-types-of-wound-debridement.html

The description of selective or nonselective debridement are used in CPT code assignment. 

Selective debridement (CPT codes 97597-97598) is the removal of nonviable tissue. Unlike excisional debridement, the physician removes no living tissue in a selective debridement.

 

Non-selective debridement (CPT code 97602) is the gradual removal of nonviable tissue and is generally not performed by a physician.

I would suggest to educate your podiatrists the needs for what is required to code excisional debridement in ICD-10 PCS to assure you are capturing the extent of the procedure.