Mar 28th, 2016 - codinqueen 57
re: debridement of sacral decubitus ulcer encluding bone.
If MD removed portions of bone I would use CPT® 15933 if only primary suture was done. Because of the typo I am unsure if MD included or excluded bone in the debridement. If no bone removed I would use 15931, if only primary suture was done. If MD did skin flap closure or myocutaneous graft, you would need 15936 only if no ostectomy plus the graft code for the type of graft MD used. If ostectomy was done and skin flap or myocutaneous graft closure you would need 15937 & the flap or graft CPT® code. I would check the path rept and see if there is any bone represented if the op is not clear, or query the MD if he did an ostectomy.
You didn't tell us what kind of closure other than they "backed" the wound (backed it with what?) but you said MD included bone (unless that typo of "encluding" was supposed to be "excluding" instead of "including") with the debridement.
I think if bone was removed, even by sharp debridement, it would still be considered an ostectomy with excision of the ulcer. I would stay away from 11044 since this is a decubitus ulcer and as such has its own category of CPT® codes. If you have a Coders Desk Reference, refer to it, might be of help. Because this a an expensive reference, I have an OLD (2008) Coders Desk Reference book and most of the explanations are still accurate. I have checked this explanation in my 2008 book against the 2016 CDR for these codes on my encoder for this answer. I suggest personally investing in a Coders Desk Reference- it is a big help.