Podiatry Procedure

veloso

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Hi All,
Can somebody help me find a CPT code because someone's opinion is 11042? and the other is 11055? attached is the Operative Report;

Patient seen and evaluated
Patient educated about proper diabetic foot care
Recommend to check feet daily for any changes
Patient advised to speak to PCP about taking medication for her numbness *
Aseptic debridement of hyperkeratotic lesions x 2 with sterile #15 blade without complications - left calf.
Referral to Vascular *
Patient expressed verbal understanding of all instructions
RTC 6 months

THANKS
 

espressoguy

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Tacoma, WA
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As this is a hyperkeratotic lesion I would go with 11055.

11042 is typically used for debridement of ulcers and open wounds down to and including subcutaneous tissue. There are specific guidelines to use this code, most of which are not found in your procedure note.
 

veloso

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Hi Mark,

Thanks for the immediate attention BUT I was told that 11055 if done with 'Paring and Cutting" please advise.

Veloso
 

tdvrana

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11042 vs 11055

what were you using for a diagnosis code? The way the provider described it "hyperkeratotic lesion", that's essentially a callus, which is L84 and not covered by 11042. But the thing we're wondering now is whether L84 with 11055-57 is covered at all anymore. It doesn't look like Medicare is covering it no matter how it's coded. We're thinking if a provider simply does paring of a callus, it is just part of an e/m visit.
What are everyone else's thoughts on this?
 
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