February 6, 2014
We billed 11000 (Debridement of extensive eczematous or infected skin; up to 10% of body surface) for debridement of an ear canal with a diagnosis code of otitis externa (380.23). The payor denied 11000 and say there was no “medical necessity” documented. I don’t get it. Please help.
The denial occurred because 11000 is an integumentary system, or skin, code and not appropriate to use for a procedure performed in the ear canal. The ear canal debridement is included in your E&M code and you may also report 92504 if binocular microscopy was used for the procedure.