I have a provider that is billing CPT 11055. It is hitting an Edit that "this code is only allowed 1 time per 60 days." Medicare is the Primary Payor. The diagnosis used are correct per the LCD.

Procedure:

Debridement/Procedure Level: Excision callus
Instrument Used: Curette
Anesthesia 2% lidocaine jelly
Bleeding: Small
Bleeding Control: Pressure
Added Pain Control: none
Specimen Taken: None
Total Surface Area of Debridement: 0.1 cm2

I’m having a difficult finding any information on this edit. If anyone has any information where I can look for this.

Thank you