Wiki Wound Care - parent codes specifically

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Sparky79

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Is anyone else having problems billing the new add on codes 11045,11046,11047 or the
97598. The parent codes specifically state first 20 sq cm and the add-on codes are for each additional 20 sq cm.
We have been running into many denials if the wound is large enough to need mutiple units of the add-on codes and we quantity bill them.

Suggestions on this topic are greatly appreciated.

Thank you!:)
 
I'm in NC and Palmetto (Medicare carrier) wants a -59 on the add-on codes. Crazy I know but we kept running into denials until I added the -59 and lo and behold then they paid those lines. :eek:
 
Try appealing your denials with notes, preferably with pictures, if available. I've found that large wound debridements are almost always denied, but paid on appeal.

As Grintwig mentioned, you may have to add mod 59. Some insurance wants the add-on codes on separate lines rather than units.
 
I have been running into the same problem with Medicare in Missouri. I have been appealing wtih notes and pictures but they keep denying.
 
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