Wiki Modifier 76 with 11042 and 11045, 11043 and 11046, and 11044 and 11047

[bsievering]

Hi!

I do physician billing and have a question regarding procedures 11042, 11045; 11043, 11046; and 11044, 11047

If a physician is debriding a wound and has debrided a total of 5 20's - what would be the correct way to bill?

Example:

Physician debrides a necrotic pressure ulcer of the right thigh. On his super bill, he has marked to bill 1 11043 and 4 11046. How would you code this? 11043, 11046 x 4? 11043, 11046-59 x 4? or 11043, 11046-76 x 4?

There are only two of us that have taken or are taking coding classes at this time. We are both unsure on how to do this, but both disagree with our understanding of the courses we've taken.

Any help would be greatly appreciated!

 

[mitchellde]

A add-on code does not need a modifier. so if your documentation supports 100 sq cm debrided the you would bill the 11043 and 11046 X 4 units.

 

[Kokila R]

1st degree burn

Hi Debra,

I always wonder about your answers. You explain very clearly and professionally.

I would like to clarify with you about first degree burn care:

Patient diagnosis - First degree burn of right hand

In MDM note, bacitracin applied is documented. No silvadene applied.


Kindly confirm bacitracin(antimicrobial) alone support to code CPT 16000 or else what are the points we should see to code 16000.

Thanks,
Kokila Ragul CPC.

 

[mitchellde]

Thank You for the compliments.
to bill a 1600 for a first degree burn treatment, the provider would need to document that the burn was cleansed and then the ointment applied with any dressing and subsequent treatment instructions. To document only that ointment was applied is not sufficient documentation to support the procedure.

 

[bsievering]

Thank you, Ms. Debra! That is that way I was thinking it should be coded as well. However, Medicare did not pay anything when I did code without the modifiers. Talk about confusing!