2025 CPT code 11006
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Debridement of skin, subcutaneous tissue, muscle, and fascia for necrotizing soft tissue infection affecting the external genitalia, perineum, and abdominal wall, with or without fascial closure.
Modifiers 59 (Distinct Procedural Service) and 78 (Unplanned Return to the Operating/Procedure Room) may be applicable depending on specific clinical scenarios and additional procedures performed.
Medical necessity for this procedure is established when a patient presents with a necrotizing soft tissue infection involving the specified anatomical regions.The infection is characterized by rapidly progressing necrosis, often accompanied by systemic symptoms such as fever, hypotension, or sepsis.The procedure is medically necessary to remove infected tissue and prevent further spread of the infection, potentially saving the patient's life or limb.
The physician's responsibilities include evaluating the extent of necrotic tissue, performing the debridement using appropriate surgical techniques, controlling bleeding, administering antibiotics if necessary, and closing the fascia (if indicated).Pre-operative preparation and anesthesia are also considered part of the clinical responsibility, though not explicitly coded.
In simple words: This code covers the surgical removal of dead or infected tissue from the skin and deeper layers in serious infections affecting the genitals, area between the legs, and abdominal wall.The doctor cleans out the infection, removes the dead tissue, and may close the abdominal wall if needed.
This CPT code encompasses the debridement of necrotic tissue involving the skin, subcutaneous tissue, muscle, and fascia in cases of necrotizing soft tissue infection. The affected areas include the external genitalia, perineum, and abdominal wall.The procedure may or may not include fascial closure.Surgical instruments such as scalpels, scissors, and other tools are used to remove the dead tissue while preserving as much viable tissue as possible. Hemostasis is achieved, antibiotics may be applied, and the wound is packed with saline-soaked gauze.This procedure requires an operative report for accurate billing.
Example 1: A 65-year-old diabetic male presents with Fournier's gangrene (necrotizing fasciitis of the perineum).The surgeon performs debridement of necrotic tissue involving the skin, subcutaneous tissue, muscle, and fascia of the perineum and external genitalia.Fascial closure is performed., A 40-year-old female post-abdominal surgery develops a necrotizing soft tissue infection in the abdominal wall. The surgeon performs debridement of the involved skin, subcutaneous tissue, muscle, and fascia.Fascial closure is not needed., A 72-year-old male with compromised immunity develops a necrotizing infection affecting the external genitalia and perineum.The surgeon performs debridement of necrotic tissue involving skin, subcutaneous tissue, and fascia.Due to the extent of tissue damage, fascial closure is delayed and the wound is left open for secondary intention healing.
A detailed operative report is crucial for accurate coding and reimbursement.The report should specify the extent of tissue involvement (skin, subcutaneous tissue, muscle, and fascia), anatomical locations (external genitalia, perineum, abdominal wall), and whether fascial closure was performed.Pre-operative and post-operative diagnoses, including microbiology results, should be included.
** This procedure is time-sensitive and should be performed as soon as possible after diagnosis of a necrotizing soft tissue infection.The choice to perform fascial closure depends on the extent of tissue damage and the surgeon's judgment.Careful documentation is crucial for appropriate billing and reimbursement.
- Revenue Code: P6A (Minor Procedures - Skin)
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this code.
- Specialties:General Surgery, Plastic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center