In your case, the wound is being closed with a split thickness skin graft so the debridement codes are not accurate in this situation. recommending their use. not endorsed by the AHA or any of its affiliates. End User License Agreement: without the written consent of the AHA. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. 0000007521 00000 n Q4102 . Applications are available at the American Dental Association web site. 0000006208 00000 n You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. Refer to NCCI and OPPS requirements prior to billing Medicare.For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.The diagnosis code(s) must best describe the patient's condition for which the service was performed. Services exceeding this intensity and duration of treatment will be considered not medically necessary. Based on what I have read in the Official Guidelines for Coding and Reporting and Coding Clinic for ICD-9-CM, I believe that I should report two separate codes. You will see two additional references: benign and malignant. |S=LqO=Vz The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, The CMS.gov Web site currently does not fully support browsers with What does Separate Procedure Mean in a CPT Code Description? Subsequent debridement is often more superficial and best described by CPT codes 97597 or 97598 rather than 11043 or 11044. Each pair of codes identifies the size of the defect created by the surgical preparation, with the first code (15002 or 15004) describing the first 100 sq cm for adults and children aged 10 and up, or 1 percent of body surface area for children under 10 years of age, including infants. Examples of the inappropriate use of these codes are ulcers, furuncles, and localized skin infections. 0000010490 00000 n Youll find the codes for skin substitute graft procedures in the range 15271-+15278 (Application of skin substitute graft ). Applicable FARS\DFARS Restrictions Apply to Government Use. Wound care debridement codes 1104211047 Use these codes when the only procedure performed in wound debridement. There are lessons to be learned to avoid damaging coding habits. Youll find the codes for skin substitute graft procedures in the range 15271-+15278 (, o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm, o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children), Face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/ or multiple digits, You can still separately code for deep debridement that includes muscle and bone, says, Grasp measurement rules. You can use the Contents side panel to help navigate the various sections. o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm This page displays your requested Article. presented in the material do not necessarily represent the views of the AHA. Complete documentation for excisional debridement requires five elements, including: i. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). If your session expires, you will lose all items in your basket and any active searches. If infection has developed, the patient's response to this infection should be described. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. For services related to removal of callus (hyperkeratotic tissue) around an ulcer, paring or cutting of corns, trimming or debridement of nails, please refer to NGS LCD Routine Foot Care and Debridement of Nails (L33636). 0000013585 00000 n Likewise, the Arobella Qoustic Wound Therapy System uses an ultrasonic assisted curette to debride wounds mechanically. In the presence of documented significant ischemic disease with necrotic ulceration, extensive and definitive debridement may be required. LGXt5q]$]0"$T ?@Z"&&g2~caPa;SS:Sk \SA?3U'VXAHKJ66 R f`p/2XNd@T1 Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. American Hospital Association ("AHA"), Reader Question: Distinguish Additional Lesion Excision Method, CCI Edits: Navigate Surgery Bundles That Could Compromise Your Pay, ICD-10 Changes: Master Guidelines for Infection, Sepsis. 3. cm of the total 85.25 sq. We are looking for thought leaders to contribute content to AAPCs Knowledge Center. qe<>O &j'>-3c\BMAi`/@SPPkS u6X \[bkjqkXdV41+ahqg& _p,d4ueQ@Ha s0O The patient's medical record must contain documentation that fully supports the medical necessity for services included withinthe related LCD. Secondary Payor Doesnt Recognize Consultations. Answer: The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contractures ). 3]HE1}}&Z\d3aD)6C~NYZgois\t-w;s3N>dgp@GtBisMaq)%le"Z\g.j4 9qEb*NLaQD\/z a\)DC|[JkHHq\J.d&X. F(P.Q@/Q _(g Remember: Wound surface area is what you should consider when selecting the code, not the size of the graft, cautions Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan. Bill types and Revenue codes have been removed from this article. Remember that the debridement codes, 11042-11047, are reported when you debride an open wound that will stay open to heal by secondary intention. 1309 0 obj <>stream Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. Otherwise, the graft code would have an includes note indicating the debridement is inherent in the code. View ICD-10-PCS CODING 2022 - Case Studies and Code Building Exercises.docx from HLTH 1241 at St. John's University. The AMA assumes no liability for data contained or not contained herein. If billed by a hospital subject to OPPS for an outpatient service, these CPT codes will be paid under the OPPS when the service is not performed by a qualified therapist and it is inappropriate to bill the service under a therapy plan of care. endstream endobj startxref {B$0{@-g;E*m ZhP' 94*_@0C"EXOeB0]:w`;d3Qf)2 }q)e]wNa%FS|C|N/\Z ZLA&0aC`+9MA- 9[cBo}gi;>E\H%2PXus |,"y5q+p^$C-y#]+vJ%@|6 : &TI=C$^';Ez^J=SZ-gZ What does Separate Procedure Mean in a CPT Code Description? Another option is to use the Download button at the top right of the document view pages (for certain document types). o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children) Skin substitute grafts include the following: Many claims for debridement are essentially dressing changes and are not separately payable. 7500 Security Boulevard, Baltimore, MD 21244. 0000020105 00000 n 0000002478 00000 n You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. As used herein, "you" and "your" refer to you and any organization on behalf of which you are acting. CPT Procedure Codes. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. Auto- is different: If you see the term autograft or tissue cultured autograft, then you are dealing with the harvest and/or application of an autologous skin graft. Anesthesia administered by or incident to the provider performing the debridement procedure is not separately payable. If a simple dressing change is performed without any active wound procedure as described by these codes, do not bill these codes to describe the service. Continuation of treatment plan with ongoing evidence of the effectiveness of that plan, including diminishing area and depth of the ulceration, resolution of surrounding erythema and /or wound exudates, decreasing symptomatology, and overall assessment of wound status (such as stable, improved, worsening, etc). 30 0 obj <>/Filter/FlateDecode/ID[<4F901E512B94F17305A37551681673A3>]/Index[25 15]/Info 24 0 R/Length 49/Prev 19234/Root 26 0 R/Size 40/Type/XRef/W[1 2 1]>>stream Per the MFSDB - payment for bilateral procedures does not apply. Revenue Codes are equally subject to this coverage determination. 11042 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less + 11045 - each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 0000012252 00000 n Thank you. CPT codes 97597 and 97598 are categorized by CMS as sometimes therapy services. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be A description of the type(s) of tissue involvement, the severity of tissue destruction, undermining or tunneling, necrosis, infection or evidence of reduced circulation. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. That means you should never report 97602 (Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session) in addition to skin graft site preparation codes. KarenZupko & Associates, Inc. 2023 | All Rights Reserved. 5. Q: I have been trying to determine whether a skin graft includes debridement. %%EOF You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. H|Wd5W5Re'c X!XFk4K|?>_/]%zWCBJ7 .`u}}`JWJz=^o\z9e~BT AT9 vqdYkh%BprY-.%V)["[n . I96w4Ak1;*8LMZI;Oe1\s &$W2DQY#"E"2$*85lm"HIl]JW)"4#F3^6F8?1HtaG]xuA*D::!83P|MnKC*{:?qk,nlG,d=atI'0 I2nC Non-excisional debridement (e.g., 97602 Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session) is described as nonsurgical because it does not involve cutting away or excising devitalized tissue. A description of the procedure as excisional CMS believes that the Internet is %PDF-1.5 % Question: The care of minor wounds (post-operative, traumatic, or otherwise) is incidental to other covered services. If any of these elements is missing, documentation does not meet the criteria for excisional debridement. Peruse CPTs Skin Replacement Surgery section, and youll see that the guidelines mention different types of skin grafts. Draft articles have document IDs that begin with "DA" (e.g., DA12345). Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "I Accept". These codes are primarily used when irrigation and . I performed a simple debridement with a full thickness graft of the trunk and reported 15200 and coded also for the debridement, but my coder told me I could not report the debridement. Autologous skin grafts are those that the surgeon harvests from another healthy part of the patients own body, and you would use different codes for those graft procedures. Frequent skilled observation and assessment of wound healing are recommended daily or weekly to justify the skilled service. jQuery(function() { _initLayerSlider( '#layerslider_57_r6v94to757da', {createdWith: '6.8.2', sliderVersion: '6.9.2', allowFullscreen: true, pauseOnHover: 'enabled', skin: 'v6', sliderFadeInDuration: 350, useSrcset: true, skinsPath: 'https://karenzupko.com/wp-content/plugins/LayerSlider/assets/static/layerslider/skins/', performanceMode: true}); }); KarenZupko & Associates, Inc. 2023 | All Rights Reserved. Size: To determine the surface area for code selection, add all areas within the same anatomic grouping, if the surgeon prepares multiple wounds. Include simple debridement: Skin replacement grafts include simple debridement of granulation tissue or recent avulsion. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Code 86.22, Excisional debridement, was defined as the "surgical removal or cutting away of devitalized tissue, necrosis, or slough," which could be performed in the operating room, emergency room, or at the patient's bedside. KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. Complete absence of all Revenue Codes indicates Tip 3: Know Whats Included I work in an acute care center with a burn unit and have been striving for accuracy and consistency. Instructions for enabling "JavaScript" can be found here. Specifically, this code is to be used for application of a skin substitute graft to a wound surface area size of 100 up to 200 sq If the wound is being excised, not just debrided, at the time of split thickness skin graft placement then you could also report a surgical preparation code (e.g., 15002, 15004) in addition to the skin graft code. If you do not agree with all terms and conditions set forth herein, click below on the button labeled "I do not accept" and exit from this computer screen. appropriate codes to use when performing a non-surgical application of a skin substitute. Auto- is different: If you see the term autograft or tissue cultured autograft, then you are dealing with the harvest and/or application of an autologous skin graft. Prior treatment by a physician, non-physician practitioner, nurse and/or therapist, Description of wound: length, width, depth, grid drawing and/or photographs, Amount, frequency, color, odor, type of exudate, Evidence of infection, undermining, or tunneling, Comorbidities (e.g., diabetes mellitus, peripheral vascular disease), Skilled plan of treatment, including specific frequency, modalities and procedures, Type of debridement performed, including instrument used, to support the debridement code billed, Changing plan of treatment based on clinical judgment of the patients response or lack of response to treatment. The views and/or positions presented in the material do not necessarily represent the views of the AHA. Service: The work described by these codes involves preparing a clean, viable wound surface for graft placement to heal by primary intention (not secondary intention). For example: Bone is debrided from a 4 sq cm heel ulcer and from a 10 sq cm ischial ulcer. This method may require the surgeon to perform "staged" debridements as the wound heals. Add skin substitute: When your surgeon performs a skin substitute graft, the supply of the skin substitute/ graft should be reported separately, according to CPT instruction. *This response is based on the best information available as of 11/16/17. Determining the wound location and surface area is important in order to select the appropriate CPT code. Debridement Codes 11000 -11001 -11000 -Debridement; up to 10% of body surface . Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. You need to master the different graft options and know how to find the information in the surgeons note, because CPT includes different code sets for each type of graft. For example, debridement of two ulcers on the foot to the level of subcutaneous tissue, total area of 6 sq cm should be billed as CPT code 11042 with unit of service of 1. iC>:D~c~V*H0"Q%L]5CB Note that debridement of the skin that is preparatory to further surgery, such as reduction of fracture, should not be coded as a separate procedure. CPT is a trademark of the American Medical Association (AMA). Before sharing sensitive information, make sure you're on a federal government site. [ 4"!|F. k Local infiltration, metacarpal/digital block or topical anesthesia are included in the reimbursement for debridement services and are not separately payable. 1 The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. If the provider debrides and sends samples for tissue typing to determine the appropriate depth, pathology found cartilage, is this considered 11044/bone? To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom Im looking at getting 11042 (debridement) and the skin graft codes precertified. 11012 skin, subcutaneous tissue, muscle fascia, muscle and bone. Please reference the CPT descriptions for application of skin substitutes codes (Attachment C). CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. of the Medicare program. required field. endstream endobj 26 0 obj <> endobj 27 0 obj <> endobj 28 0 obj <>stream (See "Indications and Limitations of Coverage.") No. The physician documentation is the key to being able to support both codes. Medicaid and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration The appearance and size of the wound (e.g., down to fresh bleeding tissue, 7 cm x 10 cm, etc.) Bottom line: Accurately coding skin substitute grafts requires lots of specific information in the medical record. Code Debridement by Documented Depth and Area When reporting debridement of a bedsore, code selection depends on the depth of debridement and total area debrided: Depth to subcutaneous tissue (to the depth of blood vessels and nerves): 11042 (first 20 sq cm) and +11045 (each additional 20 sq cm, or part thereof) All Rights Reserved (or such other date of publication of CPT). Would also adding Mod 22 help, and for which one 11042 or 11043? Do not report 11042 -11047 in conjunction with 97597-97602 for the . Based on what I have read in the Official Guidelines for Coding and Reporting and Coding Clinic for ICD-9-CM, I believe that I should report two separate codes.Otherwise, the graft code would have an includes note indicating the debridement is inherent in the code. An operative note or procedure note for the debridement service. of every MCD page. At a minimum, the Progress Report must document the continuing skilled assessment of wound healing as it has progressed since the evaluation or last Progress Report. Should we drop Mods 59s and instead use XSs, for both 11042 and 11043? The document is broken into multiple sections. This article was converted to the new Billing and Coding Article format. rW`n":Q5g%_7:j)j9."QFGH(2My"hqt}%%l}]KkWmNhlI,(PjqK9%.v#|3^ya%h'e'e2iB@iFOk|q)7 If.ug q&QP;jNy>9cW=aB=je>m3/dDQMA;2VJ0E5&Qj2[iG"^l+E. 1 G/r f VY;fuC{r@,>^Q k1[1Q3#V^DJ;;j!E"&~'/;{1M, ~ B ^(\%@%t m+?Rh@yK 2022 HCPro, a brand of Simplify Compliance. is needed for additional grafting, bill according to the number of single units of Apligraf, To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. 465 Wound Debridement and Skin Graft Except Hand, for Musculo-Connective Tissue Disorders without CC/MCC 573 Skin Graft for Skin Ulcer or Cellulitis with MCC ,P* &r4DH#.|QW" ss Skin substitute graft codes are not to be reported for application of non-graft wound dressings (e.g., gel, powder, ointment, foam, liquid) or injected skin substitutes. RyfJwE@~:_t4lGY@iYTSBd(m6 DZk0XGxmpP+pF+ff,rBQ*A-E;qkdKom`5!0>?|;!Qb5(Hj QPiX)=Zc4cgQ+*lri59? If a physician uses a curette to debride slough on the surface of the wound is that classified as subcutaneous or non-surgical? Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Two procedure codes need to be assigned-the excision and the graft closure. This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Debridement Services. that coverage is not influenced by Bill Type and the article should be assumed to Appropriate changes in the ongoing treatment plan to reflect the clinical presentation must be present in the record. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. Article document IDs begin with the letter "A" (e.g., A12345). Answer: However, we do not recommend the 11042 11047 codes. Codes describing excision debridements deeper than skin only are organized by depth: 2. Contractors may specify Bill Types to help providers identify those Bill Types typically 43 0 obj <> endobj xref Trunk, arms, legs Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. /| Debridement is considered a separately reportable procedure when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue is removed, or when debridement is carried out separately without an immediate primary closure. I work in an acute care center with a burn unit and . application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) cm.). Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). Skin Lesion Excision Wait for Pathology? Coding Rationale The physician excised a malignant lesion from the patient's lower leg followed by closure with a split-thickness graft. Bottom line: Accurately coding skin substitute grafts requires lots of specific information in the medical record. In ICD-9-CM, the Alphabetic Index main term entry is Graft; subterm entry fascia, which directs users to code 83.82, Graft of muscle or fascia. Non-human skin substitute grafts such as xenografts (from another animal such as pig) When your surgeon treats a patient with appendicitis, you may find [], Planning can reduce consequences. All rights reserved. *This response is based on the best information available as of 09/05/19. If the surgeon leaves the wound open, you will report a debridement (11040-11044) rather than an excision. KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. cm and documented 20 sq. Do we bill 15271 as the size of the debridement documented or only the size of the skin substitute? reasonable efforts to provide accurate coding information, this information should not be construed as providing clinical advice, dictating reimbursement policy, or substituting for the judgment of a practitioner. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. All rights reserved, Debridement of the skin that is preparatory to further surgery such as reduction of fracture, etc., should not be coded as a separate procedure., The surgeon debrided the necrotic tissue surrounding the amputation site, harvested skin from the patient's thigh and closed the wound with a split thickness skin graft. hb```b``Qg`e`y @16.5&Gsf cQ"b8)l82+q {5lJ,lhn7: YZGA 3*l910eX,_ ,*KodXD78^mc0[dzMBt CMS and its products and services are Like the site preparation codes, CPT distinguishes these codes by anatomic site and wound surface area, as follows: o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm 0000001419 00000 n hbbd``b`J@ H0lV$ W0 y cm. If there is not enough clarity, then a query would be indicated. Autologous skin grafts are those that the surgeon harvests from another healthy part of the patients own body, and you would use different codes for those graft procedures. When other reconstructive procedure(s) (skin graft, myocutaneous flap, vessel graft . Non-autologous human skin (dermal or epidermal, cellular and acellular) grafts, including allografts (from a person other than the patient) and homografts (from cadavers) CPT codes 11042-11047 should be used for debridement of relatively localized areas depending upon the involvement of contiguous underlying structures. If you miss the separate skin preparation step, youll sacrifice pay your surgeon deserves. Code 86.22, Excisional debridement, was defined as the "surgical removal or cutting away of devitalized tissue, necrosis, or slough," which could be performed in the operating room, emergency room, or at the patient's bedside. iii. DISCLOSED HEREIN. 2021 Evaluation and Management Codes: Is a History Required? Secondary Payor Doesnt Recognize Consultations. Code 86.69 may be assigned twice, if desired, to show the repair of the leg ulcer.. The American Hospital Association ("the AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. authorized with an express license from the American Hospital Association. AHA copyrighted materials including the UB‐04 codes and When subcutaneous tissue is debrided from a 16 s. cm dehisced abdominal wound and a 10 sq cm thigh wound, report 11042 for the first 20 sq cm and 11045 for the second 6 sq cm. Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contractures ). In no event shall CMS be liable for direct, indirect, special, incidental, or consequential Tip 2: Identify Type of Skin Substitute Graft A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Your MCD session is currently set to expire in 5 minutes due to inactivity. 2. that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. For example, debridement of two ulcers on the foot to the level of subcutaneous tissue, total area of 6 sq cm should be billed as CPT code 11042 with unit of service of "1". twZ5C2ayV`C~1S6#9mOk)d4sr$#yd:W8 Eu1EgZ \ 0 E endstream endobj 49 0 obj <>stream and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only Add together the surface area of multiple . CMS has defined "not usually self-administered" according to how the Medicare population as a whole uses the drug, not how an individual patient or physician may choose to use a particular drug.