Wiki Debridement 11045,11046,11047 multiple units

[TAC105CPC]

Our office is having difficulty with the reimbursement of 11045,11046,11047 when the debridement is greater than 10 units. I've tried billing using units & multiple line items without success. Many of the debridements are very large non-healing wounds or ulcers. Any suggestions would be helpful.

 

[dkissel]

What payor are you billing? This makes a difference for me in how I bill. For Medicare I will bill the maximum allowable by MUE on one line then wait for the next claim run for the rest of the units (so it doesn't duplicate out.) Then I will submit a reconsideration after those units over MUE deny. I'd say about 90% of those debridements get paid that way as long as the procedure note supports the claim.

 

[TAC105CPC]

Sorry for the delay in replying. COVID 19. Medicare is the payor that we seem to have the most denials.

 

[01503628]

Hi All,

As I'm new to billing, please some one guide me with the maximum units to get paid for CPT 11046. I received the document support for 11046*40 units.
Any suggestions would be helpful.