Debridement Most Confusing ICD-9-CM Subcategory Among Coders

Debridement is the ICD-9-CM subcategory that causes the most confusion among coders, based on a study published in the summer issue of Perspectives in Health Information Management.

According to the report, debridement can be performed on skin, muscle and bone, as well as other tissues. Appropriate ICD-9-CM code assignment depends on the documentation provided in the medical record.

According to the study authors, confusion stems from inaccurate or lacking medical documentation. They recommended a further study aimed at improving coding accuracy and variation.

The study determined three criteria to identify a problematic ICD-9-CM subcategory for further study, including cost, volume and level of coding. The researchers used the Medicare Provider Analysis and Review of 2007 fiscal year data as well as expert suggestions to identify coding subcategories.

The researchers identified a list of 13 unique ICD-9-CM code categories and found that excisional debridement was the associated with the most confusion. Other confusing subcategories included complications and congestive heart failure.

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