tci Part B Insider - 2004 Issue 4

Debridement: Don't Confuse 97601 and the 11040-11044 Series, Carrier Says

One is an NPP code, the other requires more certification Getting to the bottom of debridement coding doesn't necessarily mean choosing the deepest layer of tissue.   Many providers may have been unintentionally upcoding debridement claims (CPT Codes 11040-11044) according to a posting on Part B carrier Cigna Healthcare's Web site. "Medical reviews have found that providers are confusing the depth of the wound versus the type of tissue removed when billing for debridement."   In other words, don't look at how deep the wound goes, look at the depth of tissue actually removed. Cigna cites the example...

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