How The Depth Of Debrided Tissue Informs Code Selection

When choosing the appropriate code for an ulcer debridement, be sure to base your code selection on the deepest depth of tissue that you debrided rather than the depth of the ulcer itself.

For ulcer debridement, the procedure code options include epidermis/dermis (97597), subcutaneous (11042), muscle/fascia (11043) and bone (11044) to indicate the depth of debridement that you performed.

Choose the code that reflects the deepest layer of tissue that you removed. The deepest layer of tissue removed may be different than the deepest layer of tissue exposed. For example, an ulcer may have exposed bone but that may be hard, cortical, intact bone that you choose not to debride. If the deepest layer of tissue you removed is muscle, 11043 would be the appropriate code even if there is exposed bone at the base of the ulcer.

Furthermore, if you remove more superficial layers of tissue in addition to the deepest layer, use only one code. Again, the appropriate choice is the code that reflects the deepest layer of tissue you have removed.

As with anything else in coding, always check your local coverage determination (LCD) for specific guidelines. Be aware that some LCDs may only cover 11043 and/or 11044 if you perform the debridement in an operating room.