12/23/2016

Billing for Post-Operative Bunion Removal - Foot Hardware Removal, Debridement of Bone and Packing With Antibiotic Cement

Pt is 4 months postop bunion surgery. She now has an infection at the surgical site. I am taking her back to the OR, removing hardware, debriding bone and packing with antibiotic cement. How do I bill that please?

The claim should be coded as follows:

• Removal of Hardware: 
  • 20680 - Removal of implant; deep (e.g., buried wire, pin, screw, metal band, rod or plate)

• Debridement of Bone & Packing with Antibiotic Cement: The physician surgically removes foreign matter and contaminated or devitalized bone (including epidermis, dermis, subcutaneous tissue, muscle, and/or fascia, if performed) caused by injury, infection, wounds (excluding burn wounds), or chronic ulcers. The physician uses a scalpel to excise the affected tissues into the bone. Depending on wound size, closure may be immediate or delayed. The wound may be packed open with gauze and require immediate or delayed reconstruction. Report 11044 for the first 20 sq. cm or less and 11047 for each additional 20 sq. cm or part thereof.
  • 11044 - Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. cm or less            
  • 11047 - Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq. cm, or part thereof (List separately in addition to code for primary procedure)