Z189

PDF page 560 / M10

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
SKIN AND SUBCUTANEOUS TISSUE
                                                                                     Asst           Surg        Anae
   Wound and ulcer debridement
     Debridement of wound(s) and/or ulcer(s) extending into subcutaneous tissue
 Z080 - one .....................................................................................   21.90
 Z081 - two......................................................................................   32.90
 Z082 - three ...................................................................................   49.30
 Z083 - four or more........................................................................        65.75
    Debridement of wound(s) and/or ulcer(s) extending into any of the following structures: tendon,
    ligament, bursa and/or bone
Z084 - one ..................................................................................... 65.75
Z085 - two or more ........................................................................      98.65
E542     - when performed outside hospital, to Z080, Z081, Z082,
           Z083, Z084 or Z085 ................................................... add            12.65
      Payment rules:
      1.Wound and ulcer debridement services are only eligible for payment where:
          a.the physician performs a minimum of 10 minutes of debridement; and
          b.the service is rendered personally by the physician.
      2.Suture of laceration (Z154, Z175, Z176, Z177, Z179, Z190, Z191, Z192), and complex
        laceration repair (Z187, Z188, Z189) services are not eligible for payment with wound and
        ulcer debridement services.
      3.All wound and ulcer debridement services include the application of any necessary dressing
        if rendered.
      [Commentary:
      Debridement of wound(s) or ulcer(s) must be performed personally by the physician. Wound
      dressings may be performed by the physician or by others delegated to perform wound
      dressings where such delegation is authorized in accordance with the Schedule requirements
      for delegated services. See page GP62 of the General Preamble of this Schedule.]
      Note:
      Wound dressing and wound and debridement services are not payable in addition to any
      surgical procedure unless complications require such care in excess of the usual post-
      operative care.
      Medical record requirements:
      Wound or ulcer debridement services are only eligible for payment where:
      1.the minimum time requirements involved in the debridement of the wound(s) or ulcer(s) are
        documented in the patient's permanent medical record; and
      2.Documentation supporting the debridement of each separate lesion for which a claim is
        made is found in the medical record.

PDF page 566 / M16

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
SKIN AND SUBCUTANEOUS TISSUE
                                                                              Asst        Surg          Anae
    Zone 1 repair of digit
      A complex repair of zone 1 of the digit is repair of an injury without soft tissue loss that requires
      a minimum of 20 minutes of time to perform the repair procedure.
  Z189 Complex repair, digit, zone 1 repair, without soft tissue loss,
          per digit............................................................................... 101.15
       Note:
       1.Other repair fee codes are not eligible for payment in addition to Z189 for the same zone 1
         injury.
       2.For digit tip amputations or a zone 1 injury with soft tissue loss that would requirement
         advancement, graft or other surgical method of closure, see specific listings for surgical
         repair in the Integumentary System or Musckuloskeletal System Surgical Procedures
         sections of this Schedule.
       Payment rules:
       1.Wound and ulcer debridement services, Z128, Z129, and Z114 are not eligible for payment in
         addition to Z187, Z188 or Z189 for the same repair.
       2.Z187, Z188, and Z189 include removal of any foreign bodies in the wound, irrigation and
         debridement when rendered.
       3.Plastic Surgery Procedure services (i.e. R150, R151, R152, R153 and R154) are not eligible
         for payment for any laceration repair.
       Medical record requirements:
       Z187, Z188, and Z189 are only eligible for payment where the minimum time requirements
       involved in the repair service are documented in the patient's permanent medical record. The
       time requirement includes time to perform the repair exclusive of time spent rendering any
       other separately billable service.
       [Commentary:
       For laceration repairs that do not meet the above criteria for a complex laceration repair, see
       Repair of Lacerations listings on page M15.]
    Muscle repair
# R525 - Simple muscle repair(s) to include repair of involved skin .           6           97.05          7
# R528 - Complex (see General Preamble GP12)............................        6           I.C            6

Master, record 7002. Record Layout PDF, page 1.

Z18920260401999999990000101150000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.