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13

STUDY
PLAY
DEBRIDEMENT
The removal of infected, contaminated, damaged, devitalized, necrotic, or foreign tissue from a wound
THE GOAL OF DEBRIDEMENT
Is to cleanse the woundm reduce bacterial contaminationm and provide an optimal enviroment for wound healing or possible surgical intervention
THE USUAL ENDPOINT OF DEBRIDEMENT
Is removal of pathological tissue and/ or foreign material until healthy tissue is exposed
DEBRIDEMENT TECHNIQUES
Include sharp and blunt dissection, curettement, scrubbing, and forceful irrigation.
DEBRIDEMENT OF BURNED SURFACES
CPT CODES OF 16000-16036 ARE REPORTED
types of treatment for lesions
include paring(peeling or scraping), shaving(slicing) excision( cutting, removal) and destruction ( ablation)
Macule
flat area of color change; no elevation or depression
Papule
solid elevation; less than 0.5 cm in diameter
Nodule
solid elevation 0.5-1 cm in diameter; extends deeper into dermis than papule
Tumor
solid mass; larger than 1cm
Plaque
Flat elevated surface foung where papules, nodules, or tumors cluster
Wheal
Type of plaque; result is transient edema in dermis
Vescle
small blister; greater than 0.5 cm
Scales
Flakes of cornified skin layer
Crust
Dried exudate on skin
Fissure
Cracks in skin
Erosion
Loss of epodermis that does not extend into dermis
Ulcer
Area of destruction of entire epidermis
Scar
Excess collagen production following area
Atrophy
Loss of some portion of the skin
IF MULTIPLE LESIONS ARE TREATED
Code the MOST COMPLEX LESION (highest $ amount) PROCEDURE FIRST FOLLOWED BY THE OTHERS USING MODIFIER -51 to indicate that multiple procedures were performed
Simple excision
is a full thickness (through the dermis) excision
Simple closure
is nonlayered closure
Paring of 3 common warts
CPT code: 11056 ( lesin, skin, paring/curettement); ICD-9 code: 078.19 (wart, common)
Removal of 15 skin tags
CPT code:11200 ( lesion, skin tags, removal) ICD-9 code: 701.9 (tag, skin)
shaving of 1-cm dermal lesion of face
CPT code: 11311 (lesion, skin, shaving) ICD-9 709.9 (lesion, dermal)
Reporting wound repair
following factors must be considered:
1.Length of the wound in cm
2.Complexity of the repair
3.Site of the wound
3 types of repai
1.Simple
2.Intermediate
3.Complex