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Netjai123@gmail.com

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    1. Can we bill Graft along with other procedure, say for example CPT 17250 or should we send a separate claim for Graft and a separate claim for other procedures.
    2. Can we bill nail debridement CPT 11042 / 11043 along with Graft, if the service is done on wounds/diagnoses unrelated to the wound that received the graft.
    3. Can we use modifier 59 for CPT 11042 / 11043
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    EmilyC
    Typically debridement (11042-11046) is included in graft placement when performed on the same wound.

    If the patient had multiple wounds and the physician debrided one wound, but placed a graft on a separate wound, you can bill for both the debridement and the graft with a mod 59, but the note must clearly state that wound A was debrided and wound B had a graft placement.
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    EmilyC
    There are no CCI edits saying you can't bill 17250 w/graft, but you can't use with debridement. I would also look through Medicare's policy manual. It comes up if you google "Medicare wound care guidelines" just to be sure.
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