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Question - I am new to the RHC. I have reviewed all the site I can. I have a question about the EOB and the whold. Do you know where I can find more information. or a - amount on the eob?
Hello I was wandering when is the next chapter meeting for the Bronx .I've ,missed the online one on saturday morning at 9am which usually my laundry day so I was able to log in ontime but still had time to be in the meeeting
  1. Can we bill Graft along with other procedure, say for example CPT 17250 or should we send a separate claim for Graft and a separate claim for other procedures.
  2. Can we bill nail debridement CPT 11042 / 11043 along with Graft, if the service is done on wounds/diagnoses unrelated to the wound that received the graft.
  3. Can we use modifier 59 for CPT 11042 / 11043
E
EmilyC
Typically debridement (11042-11046) is included in graft placement when performed on the same wound.

If the patient had multiple wounds and the physician debrided one wound, but placed a graft on a separate wound, you can bill for both the debridement and the graft with a mod 59, but the note must clearly state that wound A was debrided and wound B had a graft placement.
E
EmilyC
There are no CCI edits saying you can't bill 17250 w/graft, but you can't use with debridement. I would also look through Medicare's policy manual. It comes up if you google "Medicare wound care guidelines" just to be sure.
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