Bilateral 11042 and Medicare

[dayzee15@yahoo.com]

Good Morning,
I am new to podiatry and cannot find any decent resources for help. If anyone has groovy links to some good information I would greatly appreciate it. My biggest concern right now is getting Medicare to pay for bilateral debridement's. No matter how I submit they are not paying me for them, single line with LT and RT modifier, single line modifier 50, 2 lines LT and RT modifier one per line, DX pointers.
Thank you

 

[CodingKing]

Its not a bilateral procedure as you don't have left and right skin. If you review the CPT book guidelines it will advise you:

"In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths"

11042 x1 for first 20sq cm total and + 11045 *1 unit each additional 20 sq cm, or part thereof.

 

[dkb6126]

agree with CodingKing. You can't use a -50 or RT or LT on that code. Sum the surface is correct.