Billing

Please consult your billing expert. However, we have provided information below from a Medicare Reimbursement Site.

From http://www.medicarepaymentandreimbursement.com/

Debridement techniques are performed to remove all tissue necessary to establish a viable margin, thus promoting healing. In addition to necrotic tissue, tissue necessary to establish a viable margin includes senescent cells, rolled skin edges, undermined edges, and abnormal granulation tissue.

Surgical debridement occurs only if material has been excised and is typically reported for the treatment of a wound to clear and maintain the site free of devitalized tissue including necrosis, eschar, slough, infected tissue, abnormal granulation tissue etc., to the margins of viable tissue.

Surgical excision includes going slightly beyond the point of visible necrotic tissue until viable bleeding tissue is encountered in some cases. The use of a sharp instrument does not necessarily substantiate the performance of surgical excisional debridement. Unless the medical record shows that a surgical excisional debridement has been performed, debridements should be coded with either selective or non-selective codes (97022, 97036, 97597, 97598, or 97602).

Surgical debridement codes as performed by physicians and qualified non-physician practitioners licensed by the state to perform those services are reported by depth of tissue removed and by surface area of the wound. These codes can be very effective but represent extensive debridement, often painful to the patient, and could require complex, surgical procedures and sometimes require the use of general anesthesia.

11042 – Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 square cm or less.

This involves removal of the above tissues using some mechanical means including scalpel, curette or equivalent means that removes these tissues. Enzymatic or autolytic debridement are not included in this definition.

11045 (add-on code for 11042) each additional 20 square cm, or part thereof.