Mechanical debridement of wound biofilm

seluka@bellsouth.netseluka@bellsouth.net
in Clinical & Coding
Hi,

Have a patient with a venous stasis ulcer who had bedside mechanical debridement of wound biofilm with gauze by the Podiatrist.  Does this get coded as a non-excisional debridement or not? 

Any help appreciated!

Comments

  • lostwaterlostwater
    Was the wound debrided, or was it an "adjustment" of the device "biofilm".  Can you see if any tissue, eschar, slough, etc. was also debrided with the biofilm?
  • seluka@bellsouth.netseluka@bellsouth.net
    Biofilm is a layer of microorganisms with cellular debris that attaches to the top of the wound.  The note just says mechanical debridement performed with 4x4 gauze to remove biofilm, dressed with wet to dry dressing. 
  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu

    If there was no excision of devitalized tissue then it is not an excisional debridement. From what you have described, this would be coded as non-excisional.


  • seluka@bellsouth.netseluka@bellsouth.net
    I agree with non-excisional if it is a valid procedure but was not sure if what was done was a valid procedure.  Have never seen debridement of "biofilm" documented.  So is this considered a valid procedure then?
  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu
    seluka@bellsouth.net said:
    I agree with non-excisional if it is a valid procedure but was not sure if what was done was a valid procedure.  Have never seen debridement of "biofilm" documented.  So is this considered a valid procedure then?

    Sounds like the MD removed the slough to get back to potentially viable tissue. But if any doubt, query the MD.
  • seluka@bellsouth.netseluka@bellsouth.net
    Ok, will do.  Thank you for your help!
  • lostwaterlostwater
    I am not so sure that it is a debridement, non-excisional or otherwise.  Wiping with gauze seems very non-invasive, very superficial, and very low utilization of resources.  I am not so sure that I would send a query to a physician lest I be accused of overkill, nor would I consider coding it as a procedure.
  • seluka@bellsouth.netseluka@bellsouth.net
    Ok thank you!
  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu

    Mark has a point there..

    Thanks for keeping me on my toes!

  • seluka@bellsouth.netseluka@bellsouth.net
    Thank you both so much for responding. I am very thankful to have access to a network of experts. :)
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