coding debridement with skin graft

Skin Substitute, Oasis wound Matrix, per square centimeter Incision and debridement, right knee Exchange arthroplasty liner of right total knee arthroplasty OPERATIVE NOTE: . 0000004501 00000 n Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "I Accept". Peruse CPTs Skin Replacement Surgery section, and youll see that the guidelines mention different types of skin grafts. rW`n":Q5g%_7:j)j9."QFGH(2My"hqt}%%l}]KkWmNhlI,(PjqK9%.v#|3^ya%h'e'e2iB@iFOk|q)7 If.ug q&QP;jNy>9cW=aB=je>m3/dDQMA;2VJ0E5&Qj2[iG"^l+E. 1 G/r f VY;fuC{r@,>^Q k1[1Q3#V^DJ;;j!E"&~'/;{1M, ~ B ^(\%@%t m+?Rh@yK Left axillary artery to left femoral artery bypass with an 8 mm PTFE graft INDICATIONS: . We are looking for thought leaders to contribute content to AAPCs Knowledge Center. 0000020105 00000 n . Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). 0000017002 00000 n These codes are used for wound debridement but only when you are debriding an open wound with no intention of closing it; you expect the wound to heal by secondary intention. Supplies such as A6453 (Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard) are included in the skin application charge. cm of the total 85.25 sq. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. /| When other reconstructive procedure(s) (skin graft, myocutaneous flap, vessel graft . In cases of excessive frequency or prolonged duration of treatment, documentation should include an evaluation for possible infection (e.g. Earn CEUs and the respect of your peers. 0000010490 00000 n article does not apply to that Bill Type. and monitoring is occurring. an effective method to share Articles that Medicare contractors develop. The procedure is essential for wounds that aren . End User License Agreement: The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Codes describing excision debridements deeper than skin only are organized by depth: 2. Article document IDs begin with the letter "A" (e.g., A12345). 0000044306 00000 n CPT considers debridement a separate procedure only when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure. cm). Im taking a patient to the OR for debridement of a dehiscent surgical wound and will skin graft it for closure. While every effort has been made to provide accurate and 2. Examples of the inappropriate use of these codes are ulcers, furuncles, and localized skin infections. To participate in the NAHRI forum discussions, you must be a member of the NAHRI community. Non-human skin substitute grafts such as xenografts (from another animal such as pig) 0000002443 00000 n Your coder is correct simple debridement is included in the graft codes. What does Separate Procedure Mean in a CPT Code Description? You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. 4. Secondary Payor Doesnt Recognize Consultations. cm and not just that the size of the skin substitute was 20 sq. The views and/or positions presented in the material do not necessarily represent the views of the AHA. endstream endobj 1254 0 obj <>/Metadata 102 0 R/OCProperties<>/OCGs[1280 0 R]>>/Outlines 119 0 R/PageLayout/SinglePage/Pages 1245 0 R/StructTreeRoot 186 0 R/Type/Catalog>> endobj 1255 0 obj <>/ExtGState<>/Font<>/Pattern<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 1256 0 obj <>stream Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be without the written consent of the AHA. Wound care debridement codes 1104211047 Use these codes when the only procedure performed in wound debridement. By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. You can collapse such groups by clicking on the group header to make navigation easier. Include cleaning: When the surgeon performs a simple cleansing of the wound, that service is included within the skin substitute procedure codes, according to CPT instruction. Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. cm of the total 85.25 sq. You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. 465 Wound Debridement and Skin Graft Except Hand, for Musculo-Connective Tissue Disorders without CC/MCC 573 Skin Graft for Skin Ulcer or Cellulitis with MCC Distinguish the codes based on body site, as follows: 11042 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less + 11045 - each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contractures ). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. %%EOF You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. The AMA assumes no liability for data contained or not contained herein. 0000011649 00000 n Report these procedures, when they represent covered, reasonable and necessary services, using the CPT or HCPCS code that most closely describes the service rendered. iv. Addition to Skin Graft Codes. Codify Subscriber Answer: You should [], Copyright 2023. An ulceration of the distal right leg was also noted and repaired with split thickness skin graft., Assign code 84.3 (revision of amputation stump) and code 86.69 (other skin graft to other sites) for the debridement and closure of the amputation site via split-thickness skin graft. 0000018702 00000 n Therefore, the more accurate code is a surgical preparation code (15002 15005) for excision (note the term is not debridement) of the open wound to prepare a viable wound surface for grafting. This page displays your requested Article. This is reported with a single code, 11044. When your surgeon treats a patient with appendicitis, you may find [], Planning can reduce consequences. Include simple debridement: Skin replacement grafts include simple debridement of granulation tissue or recent avulsion. If you miss the separate skin preparation step, youll sacrifice pay your surgeon deserves. R'7bd snYJ@ 9PE@ cL endstream endobj 44 0 obj <>>> endobj 45 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Tabs/W/Thumb 35 0 R/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 46 0 obj [/ICCBased 68 0 R] endobj 47 0 obj <> endobj 48 0 obj <>stream Remember: Wound surface area is what you should consider when selecting the code, not the size of the graft, cautions Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS, DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), Some older versions have been archived. Grasp measurement rules. endstream endobj 26 0 obj <> endobj 27 0 obj <> endobj 28 0 obj <>stream v. The depth of the debridement (e.g., to skin, fascia, subcutaneous tissue, muscle, or bone). Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contractures ). A description of the instrument used to cut or excise the tissue (e.g., scissors, scalpel, curette) For instance, Versajet debridement is considered to be nonsurgical, mechanical debridement because it does not involve cutting away or excising devitalized tissue. The National Correct Coding Initiative (NCCI) bundles skin substitute graft codes 15271-+15277 with skin and subcutaneous debridement code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less). Two procedure codes need to be assigned-the excision and the graft closure. This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Debridement Services. Photographic documentation of wounds either immediately before or immediately after debridement is recommended for prolonged or repetitive debridement services (especially those that exceed five extensive debridements per wound (CPT code 11043 and/or 11044)). 2021 Evaluation and Management Codes: Is a History Required? Tip 2: Identify Type of Skin Substitute Graft If there is not enough clarity, then a query would be indicated. hbbd``b`J@ H0lV$ W0 y At a minimum, the Progress Report must document the continuing skilled assessment of wound healing as it has progressed since the evaluation or last Progress Report. endstream endobj startxref In the presence of documented significant ischemic disease with necrotic ulceration, extensive and definitive debridement may be required. Contractors may specify Bill Types to help providers identify those Bill Types typically Otherwise, the graft code would have an includes note indicating the debridement is inherent in the code. authorized with an express license from the American Hospital Association. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. ii. 5. Appropriate changes in the ongoing treatment plan to reflect the clinical presentation must be present in the record. Debridement of diabetic foot ulcers more frequently than once every seven (7) days, for a period longer than three (3) months may not be reasonable and necessary. Cornerstones of chronic foot ulcer management include relief of pressure, control of infection and appropriate debridement. *This response is based on the best information available as of 09/05/19. The medical record should include the following information: The documentation must include that if indicated, ongoing pressure relief has been prescribed, for example, shoe inserts, modifications, padding, frequent position changes, etc. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. Supplies such as A6453 (Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard) are included in the skin application charge. To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. U.+"x/J>DcB This method may require the surgeon to perform "staged" debridements as the wound heals. Select Debridement Codes by Depth. 1 Initial debridement may be deep and through skin, subcutaneous tissue, muscle fascia, and muscle. The patient's medical record must contain documentation that fully supports the medical necessity for services included withinthe related LCD. Tip 1: Capture Site Preparation However, we do not recommend the 11042 - 11047 codes. Coding matrix for the new skin substitute graft codes For multiple wounds, sum the surface area of all wounds requiring grafts from the same anatomic site and report the applicable primary code and add-on code in multiples, as appropriate. 15271-15278 is the new CPT code series for skin substitute grafts. Complete absence of all Bill Types indicates Youll find the codes for skin substitute graft procedures in the range 15271-+15278 (Application of skin substitute graft ). Skin Lesion Excision Wait for Pathology? Coding and Billing for Skin Substitute Grafts Skin substitute graft application code selection is based on defect site location and size. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). 2. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816. %PDF-1.7 % In addition to the type of graft material, the surgeon should also document site preparation and wound size, and number and location of grafts, according to Beresh. The treatment plan for a patient who requires frequent repeated debridement should be reevaluated, to ensure that pressure reduction and infection control have been adequately addressed. resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. CMS believes that the Internet is pls help me whether to code manually debrided ones. required field. Youre right about the skin graft code(s). 1309 0 obj <>stream that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. Auto- is different: If you see the term autograft or tissue cultured autograft, then you are dealing with the harvest and/or application of an autologous skin graft. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. CMS and its products and services are not endorsed by the AHA or any of its affiliates. F(P.Q@/Q _(g hb```f``e`2jx Y8t00:00@9@ 6 jx If the wound is being excised, not just debrided, at the time of split thickness skin graft placement then you could also report a surgical preparation code (e.g., 15002, 15004) in addition to the skin graft code. The views and/or positions 0000016096 00000 n In your example, you will be closing the wound. The Medicare program provides limited benefits for outpatient prescription drugs. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, You can use the Contents side panel to help navigate the various sections. "JavaScript" disabled. Answer: Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. In your example, you will be closing the wound. Providers are reminded that the CPT code used to report the debridement must represent the level of debridement and not the depth of the ulcer. The objective of the procedure is to . My coder says that 11043/11046 is included in 15271 and we can't separately bill for them with 15271. You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles, You are leaving the CMS MCD and are being redirected to, AMA CPT / ADA CDT / AHA NUBC Copyright Statement, Article - Billing and Coding: Debridement Services (A56617). License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Trunk, arms, legs There are multiple ways to create a PDF of a document that you are currently viewing. Not exactly. Local infiltration, metacarpal/digital block or topical anesthesia are included in the reimbursement for debridement services and are not separately payable. Tip 3: Know Whats Included A description of the procedure as excisional preparation of this material, or the analysis of information provided in the material. Debridement services are now defined by body surface area of the debrided tissue and not by individual ulcers or wounds. that coverage is not influenced by Bill Type and the article should be assumed to Distinguish the codes based on body site, as follows: Each pair of codes identifies the size of the defect created by the surgical preparation, with the first code (15002 or 15004) describing the first 100 sq cm for adults and children aged 10 and up, or 1 percent of body surface area for children under 10 years of age, including infants. Refer to NCCI and OPPS requirements prior to billing Medicare.For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.The diagnosis code(s) must best describe the patient's condition for which the service was performed. hb```b``Qg`e`y @16.5&Gsf cQ"b8)l82+q {5lJ,lhn7: YZGA 3*l910eX,_ ,*KodXD78^mc0[dzMBt Bottom line: Accurately coding skin substitute grafts requires lots of specific information in the medical record. The second code in each set (+15003 and +15005) are add-on codes that you should report for defect area beyond the initial size (for each additional 100 sq cm or 1 percent of body area or part thereof). When performing debridement of a single wound, report depth using the deepest level of tissue removed. 0000017393 00000 n Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Terms: Primary intention means that the edges of the wound or graft are closed to allow them to grow together, while secondary intention refers to allowing an open wound to heal from the base up by building new tissue. Use of CPT codes 11000-11047 is not appropriate for the following services: washing bacterial or fungal debris from feet, incision and drainage of abscess including paronychia, avulsion of nail plates, acne surgery, destruction of warts, or burn debridement. copied without the express written consent of the AHA. Service: The work described by these codes involves preparing a clean, viable wound surface for graft placement to heal by primary intention (not secondary intention). complete information, CMS does not guarantee that there are no errors in the information displayed on this web site. Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. Specifically, this code is to be used for application of a skin substitute graft to a wound surface area size of 100 up to 200 sq Federal government websites often end in .gov or .mil. 11011 skin, subcutaneous tissue, muscle fascia and muscle. Please visit the. . %PDF-1.5 % If the documentation supports that 20 sq. Guidance on these codes is available in the Bill type and Revenue code sections. An official website of the United States government. CPT is a trademark of the American Medical Association (AMA). Application of Bioengineered Skin Substitutes and Skin Grafting is performed on ulcers that are free of . hVmo6+ER|l%v5/:Bm#e'b|x;CA\X&V@[ ElBdd B()"8$^DHhFTDv):7^L]c"BJ#=,'$T#BJ! Complete documentation for excisional debridement requires five elements, including: i. All rights reserved, Debridement of the skin that is preparatory to further surgery such as reduction of fracture, etc., should not be coded as a separate procedure., The surgeon debrided the necrotic tissue surrounding the amputation site, harvested skin from the patient's thigh and closed the wound with a split thickness skin graft. Answer: What does Separate Procedure Mean in a CPT Code Description? 43 0 obj <> endobj xref 0000002591 00000 n 0000016569 00000 n Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. The patient's comorbid medical and mental condition, and all health factors that may influence the patient's ability to heal tissue, such as, but not limited to the following: mental status, mobility, infection, tissue oxygenation, chronic pressure, arterial insufficiency/small vessel ischemia, venous stasis, edema, type of dressing, chronic illness such as diabetes mellitus, uremia, COPD, malnutrition, CHF, anemia, iron deficiency, and immune deficiency disorders. 5. In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. An asterisk (*) indicates a Note that debridement of the skin that is preparatory to further surgery, such as reduction of fracture, should not be coded as a separate procedure. What are the 2020 CPT code changes? qe<>O &j'>-3c\BMAi`/@SPPkS u6X \[bkjqkXdV41+ahqg& _p,d4ueQ@Ha s0O Debridement is generally associated with injuries, infections, wounds, and/or ulcers. A description of the tissue removed (e.g., necrotic, devitalized or non-viable) 15004 and +15005 for face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits damages arising out of the use of such information, product, or process. U B( B>i ^6XPw1E_H*>4=i"U}`K}1~ymIoq=wza This note should describe the anatomical location treated, the instruments used, anesthesia used if required, the type of tissue removed from the wound, the depth and area of the wound and the immediate post procedure care and follow-up instructions. You're right about the skin graft code (s). presented in the material do not necessarily represent the views of the AHA. Reduction of pressure and/or control of infection will facilitate healing and may reduce the need for repeated debridement services. will not infringe on privately owned rights. Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. When debridements are performed, the debridement . In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths. 465 Wound Debridement and Skin Graft Except Hand, for Musculo-Connective Tissue Disorders without CC/MCC Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. Answer: Debridement is considered a separately reportable procedure when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue is removed, or when debridement is carried out separately without an immediate primary closure. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. Supportive Documentation Requirements (required at least every 10 visits) for 97597 and 97598: Medical records must be made available to Medicare upon request. If you would like to extend your session, you may select the Continue Button. iC>:D~c~V*H0"Q%L]5CB Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. 0000000016 00000 n He is an alumnus of York College of Pennsylvania and Clemson University. Bilateral Carpal Tunnel Procedures Different Days, Multiple Laminectomies to Place a Spinal Cord Stimulator. CPT Procedure Codes. These unique codes are classified as per the anatomic site (general and specific body. Remember that the debridement codes, 11042-11047, are reported when you debride an open wound that will stay open to heal by secondary intention. 3. Debridement is the removal of dead (necrotic) or infected skin tissue to help a wound heal.

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