Using the CPT and ICD-10-CM manuals, code the following services: D) Debridement; 16 sq. cm. subcutaneous tissue and muscle due to a diabetic foot ulcer. CPT code: _ ICD-10 code: ICD-10 code: E) Excision of abscessed pilonidal cyst; complicated. CPT code: ICD-10 code: F) Debridement of four fingernails due to onychomycosis. CPT code: _ ICD-10 code
The Correct Answer and Explanation is:
D) Debridement; 16 sq. cm. subcutaneous tissue and muscle due to a diabetic foot ulcer
- CPT code: 11043
- ICD-10 code: E11.621 (Type 2 diabetes mellitus with foot ulcer)
- ICD-10 code: L97.419 (Non-pressure chronic ulcer of right heel and midfoot with unspecified severity)
Explanation:
The CPT code 11043 is used for debridement involving subcutaneous tissue, muscle, fascia, and includes up to the first 20 sq. cm. Since the wound area is 16 sq. cm., this fits within the base code.
The ICD-10-CM code E11.621 identifies the patient as having type 2 diabetes with a foot ulcer, which is the systemic condition responsible for the ulcer. The second ICD-10-CM code, L97.419, specifies the location of the ulcer — on the right heel or midfoot. You may adjust the laterality or severity code depending on additional documentation.
E) Excision of abscessed pilonidal cyst; complicated
- CPT code: 11772
- ICD-10 code: L05.01 (Pilonidal cyst with abscess)
Explanation:
The CPT code 11772 refers to the excision of a complicated pilonidal cyst, which is more involved than a simple excision and usually includes wound closure, drainage, or more extensive surgery.
The ICD-10-CM code L05.01 describes a pilonidal cyst with an abscess, capturing the infectious complication.
F) Debridement of four fingernails due to onychomycosis
- CPT code: 11720
- ICD-10 code: B35.1 (Onychomycosis)
Explanation:
The CPT code 11720 is used when debridement is performed on 1 to 5 nails, whether fingernails or toenails. Since four fingernails are involved, this code is appropriate.
The ICD-10-CM code B35.1 specifies onychomycosis, a fungal infection of the nail.
Each CPT and ICD-10 code must be chosen based on the full documentation and specific details provided in the clinical scenario. Coders should also confirm the coding with the most current versions of the CPT and ICD-10-CM manuals.
