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Click here for more sample CPC practice exam questions and answers with full rationale

Size matters 11042? 24.0 cm x 13.5 cm x 2.8 cm

Hopefully you can help.

If your doctor states the following 24.0 cm x 13.5 cm x 2.8 cm non-infected ulceration involving the skin and subcutaneous tissue of the plantar lateral aspect of the thigh.

Do you multiply all these together, 24.0 cm x 13.5 cm x 2.8 cm = 907sqcm? Or do you just grab the highest, for example 24.0cm x 2.8cm = 67.2cm

The 907 seems kind of high..

Medical Billing and Coding Forum

11042 denying

Medicare Indiana constantly denies 11042 for patient who are seen weekly or after. Can someone help me code it properly with modifier to get the code paid. These are patients that comes to have ulcer debrided by the doctors.

Am I missing something?? i have used mod 59,79 even 58 to get the code paid but denies for "not deemed medical necessity". Please Help!!

Medical Billing and Coding Forum

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

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!

Medical Billing and Coding Forum