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11042 podiatry

Terri Posted Thu 02nd of February, 2017 13:28:03 PM
Is it appropriate to bill out 11042 twice? Once for Right hallux and the other for Left foot. Both places have wounds on them from diabetic ulcer. I would be billing out an 99213 with it as well. Please help.. And I thank you in advance..
SuperCoder Answered Fri 03rd of February, 2017 02:59:47 AM

Hi,

Code 11042 represents 20 sq cm or less of tissue being debrided in total. Therefore while billing, one should add up the total sq. cm's of each ulcer debrided, regardless of which foot, and if that total is 20 sq cm or less, then 11042 is billed once. If the total exceeds 20 sq cm's, then also 11042 is billed once, along with the add on code 11045 also once. Site specific modifiers are not appended with this code as skin is a continuous organ, with no laterality. Hope this helps. Thank you.

Terri Posted Fri 03rd of February, 2017 11:48:31 AM
Yes You helped me so much and I thank you for that.
SuperCoder Answered Sun 05th of February, 2017 23:33:17 PM

Happy to help!!

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