Understand Which Tissues Need to Be Debrided for 11043/+11046
Question: I have documentation for a surgical debridement where the surgeon removed devitalized tissue and other tissue, such as tendon or ligament, but they didn’t remove epidermis, dermis, subcutaneous tissue, or muscle/fascia. The patient has an ulcer, and the open wound extends to the tendon/ligament. What code should I assign for the procedure? Pennsylvania Subscriber Answer: Depending on the size of the tissue debridement, you’ll assign 11043 (Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less) and +11046 (… each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)). If the tissue area measures up to 20 sq cm, you’ll use 11043. However, if the debrided area measures beyond 20 sq cm, you’ll assign +11046 in conjunction with 11043 for every additional 20 sq cm. For example, if the patient’s wound measured 60 sq cm, you’ll report the following codes: While the descriptor for 11043 mentions “epidermis, dermis, and subcutaneous tissues,” the key phrase is what follows that information — “if performed.” This means that the code covers the debridement of those tissues if the surgeon removes affected epidermis, dermis, and subcutaneous tissues, but 11043 still applies even if they don’t remove the tissues. Mike Shaughnessy, BA, CPC, Development Editor, AAPC
