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27 Cards in this Set
- Front
- Back
Integumentary System Codes
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Provide codes for invasive procedures by physician of any speciality type.
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Codes encompass procedures performed on:
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- skin
- subcutaneous layers - nails - breast |
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Deep layers of the skin are coded how?
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-coding convention is to go to respective body system for the correct code.
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Integumentary System Terminology guides:
Complicated |
Means:
-infection occurred - treatment delayed - procedure took longer than usual *note: make sure to check note section because "complicated" can have different meanings |
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Integumentary System Terminology guides:
Excisions of Lesions: |
Clarification
- Lesions are identified by size - Lesions are identified by morphology - The size should be noted by physician -the final authority to check for size of lesions is the pathology report there can be a differences between the size of the tissue removed or excised vs the actual size of lesion. |
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Coding Excisions of Lesions
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Check the number of lesions which are included in the code.
-51 modifier may or may not need to be applied check description of the code closely. |
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Shaving:
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Means no closure is needed. The skin is simply shaved away.
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Excision
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includes SIMPLE CLOSURE of the skin post excision of a lesion.
- If the closure is complex read and be guided by the description of the closure to assign the appropriate code |
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Destruction
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By any method ie: freezing, burning, chemicals ect.
- I always remember to go to this section if there is nothing left of the lesion. No pathology report to look at, with exception of the physician taking a biopsy prior to the destruction of the lesion |
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integumentary Codes for Malignant and Benign Lesions
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There are separate codes for benign and malignant lesions
- always consult the pathology report for confirmation prior to assigning codes - Pathology report is the final owrkd even if it contradicts the physician |
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Re-excision of Malignant Lesion Site
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- Code to excision of malignant lesion
- Check with the pathology report |
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Wound Repair Coding - 3 Factors
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- length of the wound in centimeters
- complexity of repair - the site of the wound repair |
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Simple Repair
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-superficial wound, epidermis, dermis and subcutaneous tissue
- requires only ONE-LAYER suturing |
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Intermediate Repair
AKA: Layered Closure |
- closure of one or more subcutaneous tissue and superficial fascia in addition to skin closure.
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Complex Repair
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- Involves complicated wound closure including revision, debridement, extensive undermining and more than one layered closure.
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Dermabond (skin glue)
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Is considered a suture
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Sequencing Repair Codes
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Most complex repair code first
- secondary procedures will be reported with a modifier of -51 - this modifier results is a % decrease in the reimbursement received |
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What is considered part of wound repair
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- ligation, exploration, debridement (with the exception of extensive debridement for grossly contaminated tissue)
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What questions to ask when coding repairs?
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- What is the length of wound in cm?
- What is the complexity of repair? - What is site of repair? - are there any repairs that can be combined? |
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How to Find Repair Codes
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- Look under repair....wound....then type of closure
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Skin Grafts
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- Need to know the recipient site
and donor site |
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Types of Skin Grafts
Adjacent Tissue Transfer / Rearrangement |
- Z-plasty, W-plasty, V-Y plasty, rotation flaps, and advancement flaps
- Moves the tissue from one area to an ADJACENT area and leaves one side intact - coded according to size of recipient site/ square cm -simple repair of donor site is included -Excision of a lesion is included in code -How to find look under skin in the INDEX |
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Types of Skin Grafts
Free Skin Grafts Types |
- Split thickness - epidermis and part of the dermis
- Full thickness - epidermis and all of the dermis |
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Types of Skin Grafts
Free Skin Grafts Types |
Skin is freed completely from donor site
Coded according to recipient site and size - additional code if donor site requires grafting - simple repair is included in the code |
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CPT Code 15000 Preparing the recipient site
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- Does not need a modifier as per the code description
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Flaps
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-Develop donor site at location far away from the recipient site
-May have to be accomplished in stages -Delayed graft -portion of the skin is lifted and separated from tissue below, bt it still stays connected to blood vessels on one end |
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Repairs
Integumentary System Some Items Reported Separately |
- Blood Vessels
- Nerves - Tendons |