In coding, what should you do when multiple layers of tissue are excised?

When coding for excision of multiple layers of tissue, the correct practice is to focus on coding only the deepest layer excised. This is because the coding guidelines are structured to capture the most significant and comprehensive level of the surgical procedure performed. In many instances, when multiple layers are removed, coding for just the deepest layer reflects the complexity of the procedure and provides an accurate representation of the surgical service.

In this context, coding aims to ensure that the report of the procedure matches the extent of tissue removed and the surgical effort required. The rationale is that the deeper layers often encompass the more serious conditions or the more complex nature of the operation, thereby justifying the procedure’s coding based on the most extensive surgical work performed.

Although coding all layers separately may seem logical at first, it is generally not the standardized approach for layered excisions under current guidelines. Similarly, coding only the superficial layer would undervalue the procedure, and not coding excisional debridements at all would omit critical information that could affect patient care and billing. These reasons substantiate why the correct answer is to code only the deepest layer excised.