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February 5, 2023

Wound Care | CPT® Codes for Debridement

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  • Health care organizations have started wound care clinics to care for patients with non-healing wounds and frequently use wound care debridement codes to report the services
  • The care of a post-op wound is done by the surgeon in the global period, and is not separately paid, unless it is on-going and must be referred to the wound clinic
  • Often, patients treated in wound clinic have underlying vascular or metabolic problems that hinder wound closure.

This article covers common CPT® codes for debridement, documentation guidelines and related issues.

Wound care debridement codes

11042—11047 Use these codes when the only procedure performed in wound debridement.

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)

11043 – Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, If performed); first 20 sq cm or less

+11046 –  each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

11044 – Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less

+11047 –  each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

These codes are defined by depth and size, not anatomic site.

Documentation guidelines for CPT® codes 11042—11047,

  • These are the CPT wound care debridement codes
  • When a single wound has multiple depths, report one code based on the deepest level
  • When multiple wounds have the same depth, add together total square centimeters and report one code
  • For multiple wounds of different depths, report the deepest first and report additional debridement codes with modifier 59
  • Code selecting is not based on anatomic location
  • There are also  codes for debridement that includes bone, but these are not in this guide for minor procedures.

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Member resources:

  • Global Surgery Guide
  • Minor Procedures Guide
  • Modifier quick reference sheets

 

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Last revised July 26, 2022 - Betsy Nicoletti
Tags: general surgery_procedures

CPT®️️ is a registered trademark of the American Medical Association. Copyright American Medical Association. All rights reserved.

2023 E/M reference sheets

These handy quick reference sheets included at-a-glance MDM requirements for office, hospital, nursing home and home and residence services. And, a bonus sheet with typical time for those code sets. Sign up for Betsy’s monthly newsletter to download these reference sheets and share them with your practitioners.

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2023 E/M guidelines for hospital, nursing facility, home and residence services | Webinar

Effective January 1, 2023, the AMA has revised the definitions and guidelines for hospital and other E/M services, including ED visits, nursing facility services, home services, and domiciliary care codes. Also, coding for prolonged care services gets another overhaul with revised codes and guidelines. Watch this webinar about all these changes.

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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