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integumentary system

MA115 Medical Coding project
by Nabila Doupo on 19 September 2012

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Transcript of integumentary system

Integumentary System The Integumetary System subsection includes codes assigned by many different physician specialities. You may find a family practitioner using the incision and drainage, or repair codes; dermatologist using excision and destruction codes; a plastic surgeon using skin graft codes or breast procedure codes. Integumentary System The subsection is formatted on the basis of anatomic site and category of procedure. For example, and anatomic site is "Neck" and a category of procedure is "Repair" Format Skin, Subcutaneous, and Accessory Structures
Nails
Pilonidal Cyst
Introduction
Repair (Closeure)
Destruction
Breast The subsection Integumentary contains the subheadings: Incision and Drainage
Excision
Paring or Cutting
Biopsy
Removal of Skin Tags
Shaving of Epidermal or Dermal Lesions
Excision-Benign Lesions
Excision-Malignant lesions Each subheading is further divided by category, For example, the subheading Skin, Subcutaneous, and Accessory Structures is divided into the following categories: Skin, Nails, and Repair Skin Subcutaneous and Accessory Structures:
Incision and Drainage

incision and drainage codes are (10040-10180) and are divided according to the condition for what incision and drainage procedure is being performed.
● incision & drainage examples acne surgery, abscess, carbuncle, boil, cyst, hematoma
● puncture aspiration code 10160- inserting a needle into a lesion and withdrawing the fluid
● I&D codes are first divided according to the condition and then according to whether the procedure was simple or complicated
● a simple and complicated finger abscess would be reported with an incision and drainage code (26010, 26011) from the
Musculoskeletal system subsection, Hand and Finger, Incision codes Debridement & Excision Debridement promotes wound healing by reducing sources of infection
● the goal is to clean the wound, reduce bacterial
contamination, and provide the optimal environment for
wound healing
● codes in this category (11000-11047) describe services of
debridement based on depth, body surface, and condition and location
● 1st debridement codes (11000 &11001) are coded for
eczematous debridement Lesion Excision and Destruction ● 4 different treatments for lesions:
● paring- peeling or scraping
● shaving-slicing
● excision- cutting removal
● destruction- removing completely
● to code these procedures properly you must know the site, number and size of the excised lesions,as well as mailgnant ir benign
● if multiple lesions are treated code the most complex lesion procedure first followed by the others using Nails in the nails category are codes (11719-11765) for the trimming of fingernails and toenails, debridement of nails , drainage of hematomas, biopsies of nails, repair of nails, reconstruction of nail bed
● Podiatrists are physicians who specialize in the care of the foot; these physicians use these codes the most
● 1st code in the nails category is 11719, which is the trimming of nails that are not defective
● Debridement (11720) is a more complex service, the manual cleaning of up to five nails
● avulsion- the seperation and removal of the nail plate (11730, 11732) Repair When reporting wound repair, the following 3 factors must be considered
1. Length of the wound in centimeters
2. Complexity of the repair
3. Site of the wound repair
● Simple repair- superficial wound repair(12001-12021) that involves epidermis, dermis and subcutaneous tissue.
● Intermediate repair- requires closure of one or more subcutaneous tissue
● Complex repair- involves complicated wound closure including revision, debridement, extensive undermining, and more than one layer closure
● skin replacement surgery (15002-15278)
● pinch graft (15050)
● autografts (15130-15116) grafts that are taken from the patients body BURNS burns are classified as first, second and third degree based on the depth of the burn
a burn of the epidermis is a first degree burn,
a dermal burn is a second degree burn
a subcutaneous level burn is third degree.
dressing and debridment codes report either initial or subsequent treatments.
burn dressing and/ or debridement codes(16020-16030) are divided based on whether the dressing or
debridements is of a small, medium, or large area. DESTRUCTION the codes report destruction of lesions by means other than excision.
codes 17000-17004 report destruction of lesions by the number treated BREAST PROCEDURES breast procedures (19000-19499) are divided according to category of procedure.
in incisional biopsy an incision is made into the lesion and a small portion of the lesion is taken out,
in excisional biopsy the entire lesion is removed for biopsy
a partial mastectomy (19301) is one in which only a portion of the breast is removed

1. Biopsy

2. Abscess

3.Dermis

4. Excision Test Questions: a. Full- thickness removal of a lesion that may include simple closure
b. Second layer of skin holding blood vessels, nerve endings, sweat glands nad hair.
c. Localized collection of pus that will result in the disintegration of tissue over time
d. Removal of a small piece of living tissue for diagnostic purposes. 5.This condition is chronic abscessing and subsequent infection of a sweat gland a. Folliculitis
b. Hyperhidrosis
c. Miliaria
d. Hidradenitis 2012 Step-By-Step Medical Coding by Carol J. Buck

20121 ICD-9-CM, Volumes 1, 2 &3 Professional Edition

Google/images.com Reference Page 1. D
2. C
3. B
4. A
5. D Answers: Nicole Johnson:
Skin, Nail & Repair Shanita Dove: Burns,
Destruction and breast procedures Nabila Doupo: Presentation composition
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