Reporting Debridement Requires Documented Area and Depth

Correct coding of surgical debridement (11042-11047) requires documentation of both the measurement of the wound surface area after debridement and the depth of tissue that is removed. To avoid claims submission errors, denials for insufficient documentation, and potential overpayments, educate your clinicians to document these measurements as standard operating procedures for surgical debridement.
Codes describing excision debridements deeper than skin only are organized by depth:

• subcutaneous tissue (includes epidermis and dermis, if performed); 11042 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less and 11045 … each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
• muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); 11043 Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less and 11046 … each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
• bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); 11044 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less and 11047 … each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

The deepest level of tissue removed from the wound determines the correct code. For example, don’t report 11044 when bone is visible, but not documented as being part of the surgical debridement procedure. When reporting add-on codes for additional areas (e.g., 11045-11047), documentation should specify the exact areas where tissue was removed.

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John Verhovshek

John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

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