Podiatry Coding & Billing Alert

Question: I billed a claim using the codes 11040 and 11042-59-RT. The insurance paid for 11042-59-RT, but denied 11040 because of bundling edits. Insurance reps said I should bill 11040 with modifier 59, and 11042 with modifier RT, but I'm still confused. What exactly do debridement codes 11040-11044 describe?Alabama SubscriberAnswer: CPTs 11040-11044 describe debridement of relatively localized areas with or without their contiguous underlying structures. They are considered payable if the doctor removed two ulcers  on the same foot or separate foot on the same date of service.While you use 11040-11044 to treat skin ulcers, they do not refer to ulcer size. Instead, they refer to levels of  actual tissue debridement of noncontiguous skin, and other deeper tissue structures (based on tissue type, for example, partial skin, full thickness skin, or subcutaneous tissue). Tip: Medicare allows payment for a total of four independent tissue debridements on a given day of [...]