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Wound Vac with CPT Code 15002
I was hoping someone could answer a question for me. My Revenue analyst is telling us to bill a 15002, instead of a 11042 for chronic wound care when we are also doing a wound vac. In my opinion 15002 should not be used we are not prepping for tissue transfer.
Question:
I was hoping someone could answer a question for me. My Revenue analyst is telling us to bill a 15002, instead of a 11042 for chronic wound care when we are also doing a wound vac. In my opinion 15002 should not be used we are not prepping for tissue transfer.
Answer:
You're absolutely right to question this. CPT 15002 is specifically for "surgical preparation or creation of recipient site by excision of open wounds" in preparation for skin grafts or flaps. The key word is "preparation" - it's meant for wounds being readied for tissue transfer procedures.
If you're providing chronic wound care with wound vac (NPWT) therapy but not actively preparing for an immediate skin graft or flap, then 15002 is not appropriate.
CPT 11042 (debridement of subcutaneous tissue) is the correct code when you're performing debridement as part of chronic wound management, including when using negative pressure wound therapy.
Here's the distinction:
15002 = Debridement with the specific intent and plan to perform skin grafting/flap reconstruction
11042-11047 = Debridement for wound care management, infection control, or promoting healing
*This response is based on the best information available as of 11/06/25.
Therapeutic Epidural Injection
I’ve just taken on coding for pain management and could use some assistance. A patient came to our pain management clinic with chronic lower back pain. The physician performs a therapeutic epidural steroid injection at the L4-L5 interspace using fluoroscopic guidance. The physician personally performs and documents the fluoroscopic guidance. What is the correct CPT code(s) for this procedure?
Question:
I’ve just taken on coding for pain management and could use some assistance. A patient came to our pain management clinic with chronic lower back pain. The physician performs a therapeutic epidural steroid injection at the L4-L5 interspace using fluoroscopic guidance. The physician personally performs and documents the fluoroscopic guidance. What is the correct CPT code(s) for this procedure?
Answer:
Congratulations for your new role and thank you for reaching out to us. The recommended CPT code is 62323 - Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (i.e., fluoroscopy or CT).
*This response is based on the best information available as of 11/06/25.
Catheter with Angioplasty Procedure
If a third-order catheter is pulled back and enters the iliac, which is then treated with angioplasty, can you code that selective iliac catheterization in addition to the angioplasty?
Question:
If a third-order catheter is pulled back and enters the iliac, which is then treated with angioplasty, can you code that selective iliac catheterization in addition to the angioplasty?
Answer:
No, because catheterization is inclusive to lower extremity arterial revascularization interventions, such as an arterial angioplasty and stenting. Report the angioplasty only.
*This response is based on the best information available as of 10/23/25.
14000 and 19301 for Partial Mastectomy?
Should cpt code 14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM be billed with cpt code 19301 MASTECTOMY; PARTIAL. Insurances tend to disallow it stating it is included in 19301. This is how our surgeon describes 14000 a parenchymal flap advancement was used to close there is minimal breast parenchyma left at the inferior margin. Advancing this into the lumpectomy cavity does create some distortion along the inframammary fold. Therefore, the breast tissue both above and below the lumpectomy cavity is released from the underlying chest wall. They form a well vascularized broad based pedicle. This is advanced into the lumpectomy cavity and secured together with interrupted 3-0 Vicryl sutures. Approximately 10 sq cm of tissue are mobilized in this fashion. Thank you for your help.
Question:
Should cpt code 14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM be billed with cpt code 19301 MASTECTOMY; PARTIAL? Insurances tend to disallow it stating it is included in 19301. This is how our surgeon describes 14000, a parenchymal flap advancement was used to close, there is minimal breast parenchyma left at the inferior margin. Advancing this into the lumpectomy cavity does create some distortion along the inframammary fold. Therefore, the breast tissue both above and below the lumpectomy cavity is released from the underlying chest wall. They form a well vascularized broad based pedicle. This is advanced into the lumpectomy cavity and secured together with interrupted 3-0 Vicryl sutures. Approximately 10 sq cm of tissue are mobilized in this fashion. Thank you for your help.
Answer:
No, 14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM is not reported with a partial mastectomy (lumpectomy) code 19301 for a local advancement flap, which is what is described in your question
Elimination of dead space is inherent to a mastectomy procedure. Local advancement flaps and oncoplastic repair are included in a mastectomy procedure.
*This response is based on the best information available as of 10/23/25.
Needle Aspiration of Peritonsillar Abscess: Choosing the Correct CPT Code
Can you explain Peritonsillar Abscess billing 42700 vs 10160? Can we bill and defend 42700 if a provider does an FNA to evacuate a PTA?
Question:
Can you explain Peritonsillar Abscess billing 42700 vs 10160? Can we bill and defend 42700 if a provider does an FNA to evacuate a PTA?
Answer:
When a provider performs fine needle aspiration (FNA) to evacuate a peritonsillar abscess (PTA), the correct CPT code to report depends on the intent and technique of the procedure.
If it is truly a FNA and performed for diagnostic purposes, such as collecting a specimen for cytology or pathology, then CPT 10021 (Fine needle aspiration biopsy, without imaging guidance; first lesion) is appropriate.
If the provider uses a needle to evacuate pus from a peritonsillar abscess then this is considered a therapeutic aspiration, and CPT 10160 (Puncture aspiration of abscess, hematoma, bulla, or cyst) is the correct code.
According to CPT Assistant, February 2008, Volume 18, Issue 2, pages 8–9: "From a CPT coding perspective, an incision must be performed in order for an incision and drainage procedure to be reported; an aspiration procedure does not involve an incision.”
Therefore, CPT 42700, which describes incision and drainage of abscess; peritonsillar, is not appropriate unless an actual incision is made into the PTA.
*This response is based on the best information available as of 10/23/25.
63047 with 22633 for Interbody Fusion?
We would like some coding insight from KZA. Can you report CPT code 63047 with 22633 if you append modifier 51 to CPT code 63047 if the documentation supports the work done beyond that required for interbody fusion?
Question:
We would like some coding insight from KZA. Can you report CPT code 63047 with 22633 if you append modifier 51 to CPT code 63047 if the documentation supports the work done beyond that required for interbody fusion?
Answer:
Thank you for asking KZA!
CPT 63047 should not be reported with CPT 22633 at the same level/interspace.
Add-on codes (63052 & 63053) exist for decompression at the same level or interspace with a posterior lumbar interbody fusion (22630-22634). Remember, this is for decompression beyond preparation of the interspaces for fusion.
63052 – Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment
63053 – Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment
In the submitted scenario, the appropriate code to report is CPT 63052 if your documentation supports additional decompression.
*This response is based on the best information available as of 10/23/25.
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