Ambulatory Coding & Payment Report
Reader Question: Maggot Therapy
Question: I've heard that 11040 (debridement; skin, partial thickness) and 11041 (...skin, full thickness) with modifier -52 (reduced services) should be used when coding maggot therapy. Is this correct?
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Answer: Maggot therapy is a new therapy for which there is no CPT code. It is a type of debridement. CMS will pay for it in the outpatient setting under APCs as an unlisted procedure using 17999 (unlisted procedure, skin, mucous membrane and subcutaneous tissue). It will be paid at the lowest rate for debridement.
Code 97601 (removal of devitalized tissue from wound; selective debridement, without anesthesia including topical application[s], wound assessment, and instruction[s] for ongoing care, per session) could be used if the therapy was used in a setting paid under the rehab schedule.
- Published on 2001-10-01
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