Posts tagged ‘debridement’

January 23, 2011

What happens in Vegas, you take to your agency

Last chance for the Coding and Regulatory Symposium!

All of the coding and regulatory education that you learn at the Coding and Regulatory Symposium is too good to keep in Vegas! Attend the class this week, then bring back all kinds of information to share with coders, clinicians, billers, and administrators.

This conference is put on by Selman-Holman Associates. Take a look at just part of the agenda:.

  • April 2011 changes and how they impact your coding and operations
  • Wound care coding: Debridements aren’t surgical wounds, pressure ulcers never go away in coding, but they might in OASIS, and do you use aftercare of surgery (V58.xx) and wound dressing codes (V58.3x) together? These are just some of the confusing topics we’ll clear up.
  • The money follows proper coding. Really. Code by patient acuity and services, and the money will come. Learn the proper way to code and prioritize your codes.
  • HIPAA 5010 Compliance: Have you checked your checklist of where your agency should be in preparation for the changes?
  • Interactive coding both days! Sharpen your coding and OASIS interaction skills.
  • V57: Evil code or often-used friend? It should be a need-to-use code that has many guidelines surrounding its use … learn them and never worry about coding therapy again. Plus: learn the regulatory and billing issues behind it.
  • Documentation! Support your coding and appeal downcoding.

2 days of education for $385! And you’re in Las Vegas!
We’ll see you Jan. 27 and 28!

January 5, 2011

Is debridement a surgical wound?

Question: If my patient had a debridement, can I mark 1 (Yes, patient has at least one (observable) surgical wound) in M1340?

Lisa says: No, debridement is not a surgical treatment, and CMS clearly states this in its M1340 specific instructions: Debridement or the placement of a skin graft does not create a surgical wound, as these are treatments performed to an existing wound. The wound would continue to be defined as the type of wound previously identified.

However, debridement is a place where OASIS and coding may not always match up. For example, you can code V58.77, Aftercare of surgery of the skin and subcutaneous tissue, NEC, in some cases. For example, for a patient with a debrided diabetic ulcer of the elbow, you can code V58.77 in M1020, and then code 250.80, 707.1x in M1024. The V58.77 code as primary indicates that the focus of care is a wound that is resolving without complications and considering the complexity and chronicity of diabetic ulcers, the V58.77 code is likely not the best choice.

IF V58.77 is used, remember that as a Diabetes case-mix diagnosis, 250.80 and 707.1x can go in both M1024 and M1022, if active. This is still active, of course, so code in M1022.

Just because M1340 isn’t applicable doesn’t mean that you should forget your OASIS … M1350 includes any wounds or skin lesions OTHER than the pressure ulcers, stasis ulcers, surgical wounds already addressed, and bowel ostomies, which are also addressed in another item. The answer ‘yes’ on M1350 means that the skin lesion or wound requires intervention and assessment.