Wiki 11044

[desertsteph65]

We have a pt. who had bil BKA's. We originally biled rt and lt and Medicare said to use 27590 with 50 modifier 1 unit but double the fee. They paid this but the other code 11044 was denied. we have tried rt and lt and they have told us that this is not a bilateral procedure so you can't use a 50 modifier. Does anyone have any ideas on how to get this paid? 11044 X2 units>??
Thanks for any advice.

 

[espressoguy]

You calculate the area of all of the wounds that were debrided and then add them all together. If total area debrided is less than 20 sq cm then it is just 11044, if greater than 20 you also use the addon 11047 for each additional 20 sq cm.

Example:

Total area debrided - 8 sq cm, 11044
Total area debrided - 57 sq cm, 11044, 11047 (x2).

 

[desertsteph65]

thank you for the information.