Results 1 to 4 of 4

Excisional Debridement add on code 11045 billed to Medicare with multiple units

  1. #1
    Default Excisional Debridement add on code 11045 billed to Medicare with multiple units
    Exam Training Packages
    I had seen this discussed before but I wanted to get more feedback. Our surgeons work also in an outpatient wound center and do lots of debridements. I am receiving current denials from Medicare if I bill for over 4 units with an explanation: "information submitted does not support this many services" and also "number of days or units exceeds our acceptable maximum". They are paying on up to 4 units just fine, but if I bill for 5 or more, they deny. Is anyone else having this issue?


    Susie Smith, CPC

  2. Default multiple wound care units
    I have the same problem. Medicare told me they would have to be appealed. Refered me to MLNMM5402.

  3. #3
    Fayetteville, NC
    I have seen a large number of denials for these as well. We have had to send records with a redetermination request. It's very tedious.
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

  4. #4
    Yes it is! I just sent redetermination requests for 23 claims. I am also having Medicare deny 97598 when I bill it with 97597. They paid the 97597 but deny 97598, it's like they don't have their system updated to know that it is an add on code for 2011, not an either or code. So much time spent appealing for so little money.

Similar Threads

  1. 11045 denails with multiple units
    By ashishkokare in forum Billing/Reimbursement
    Replies: 7
    Last Post: 07-30-2015, 09:34 AM
  2. Multiple E/M units to Medicare
    By Jmeannm in forum E/M
    Replies: 1
    Last Post: 06-26-2012, 03:45 PM
  3. 11045 and Medicare units allowed
    By lwcarter in forum Plastic Surgery
    Replies: 4
    Last Post: 02-21-2012, 10:51 PM
  4. Billing multiple units to Medicare
    By TERESA TAYLOR in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 05-06-2011, 11:29 AM
  5. add on codes 11045-11047
    By coder1 in forum Dermatology
    Replies: 1
    Last Post: 04-16-2011, 11:14 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.