How To Use HCPCS Code C7500

HCPCS code C7500 describes the procedure of debridement, specifically targeting the bone, including the epidermis, dermis, subcutaneous tissue, muscle, and/or fascia. This code also encompasses the manual preparation and insertion of deep drug-delivery devices, such as subfacial implants. It is important for medical coders to understand the details and appropriate usage of this code to ensure accurate billing and reimbursement.

1. What is HCPCS C7500?

HCPCS code C7500 is used to identify the specific procedure of debridement, which involves the removal of damaged or necrotic tissue from a wound. In this case, the debridement is focused on the bone and includes the removal of the epidermis, dermis, subcutaneous tissue, muscle, and/or fascia. Additionally, this code covers the manual preparation and insertion of deep drug-delivery devices, specifically subfacial implants.

2. Official Description

The official description of HCPCS code C7500 is “Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (eg, subfacial) drug-delivery device(s).” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The provider begins the procedure by assessing the wound and determining the extent of debridement required.
2. If necessary, the provider administers local anesthesia to ensure patient comfort during the procedure.
3. The provider then carefully removes the damaged or necrotic tissue from the wound, targeting the bone and including the epidermis, dermis, subcutaneous tissue, muscle, and/or fascia.
4. If applicable, the provider manually prepares and inserts deep drug-delivery devices, such as subfacial implants, to facilitate the delivery of medication or treatment.
5. The debridement procedure is limited to the first 20 square centimeters or less of the wound.

4. When to use HCPCS code C7500

HCPCS code C7500 should be used when the provider performs debridement on a wound that involves the bone and includes the removal of the epidermis, dermis, subcutaneous tissue, muscle, and/or fascia. This code is specifically applicable when the debridement is performed on the first 20 square centimeters or less of the wound. It is important to accurately document the size and location of the debrided area to support the use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C7500, healthcare providers need to ensure proper documentation of the debridement procedure. This includes documenting the size and location of the debrided area, as well as any additional procedures performed, such as the manual preparation and insertion of deep drug-delivery devices. It is important to provide detailed and accurate documentation to support the medical necessity of the procedure and ensure appropriate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C7500 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has been consistently used to identify the specific procedure of debridement targeting the bone and including the epidermis, dermis, subcutaneous tissue, muscle, and/or fascia.

7. Medicare and Insurance Coverage

HCPCS code C7500 is eligible for coverage by Medicare. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means it is not applicable as HCPCS is priced under one methodology. Healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions regarding the coverage and reimbursement of this code.

8. Examples

Here are five examples of when HCPCS code C7500 should be billed:

1. A patient presents with a deep wound on their leg that requires debridement of the bone, including the epidermis, dermis, subcutaneous tissue, muscle, and fascia. The provider also performs the manual preparation and insertion of a subfacial drug-delivery device. In this case, HCPCS code C7500 should be used to accurately bill for the procedure.
2. A patient undergoes surgery for a complex fracture that involves the bone, muscle, and fascia. During the procedure, the surgeon performs debridement of the affected areas and inserts a subfacial drug-delivery device for post-operative medication delivery. HCPCS code C7500 should be used to report the debridement and device insertion.
3. A patient with a chronic wound on their foot requires debridement of the bone and surrounding tissues. The provider performs the procedure, including the manual preparation and insertion of a deep drug-delivery device. HCPCS code C7500 should be used to accurately bill for the debridement and device insertion.
4. A patient undergoes a reconstructive surgery that involves the removal of damaged tissue, including the bone, muscle, and fascia. The surgeon performs debridement of the affected areas and inserts a subfacial drug-delivery device for post-operative treatment. HCPCS code C7500 should be used to report the debridement and device insertion.
5. A patient with a traumatic injury to their arm requires debridement of the bone and surrounding tissues. The provider performs the procedure, including the manual preparation and insertion of a deep drug-delivery device. HCPCS code C7500 should be used to accurately bill for the debridement and device insertion.