Demystifying Value-Based Care: Managing Costs of Care-2023 Wound Management Coding Cheat Sheet

2023 Wound Management Coding Cheat Sheet

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This document provides guidelines for HBPC (Home-Based Primary Care) providers on using CPT codes for documenting debridement services in wound management. Excisional debridement involves surgically removing necrotic or devitalized tissue until healthy, viable tissue that shows bleeding is reached. The key CPT codes and their corresponding descriptions for different levels of debridement are:<br /><br />- **11042**: Debridement of subcutaneous tissue (including epidermis and dermis) for the first 20 sq. cm or less.<br />- **11045**: An add-on code for each additional 20 sq. cm of subcutaneous tissue, to be used with CPT 11042.<br />- **11043**: Debridement of muscle and/or fascia (including epidermis, dermis, and subcutaneous tissue) for the first 20 sq. cm or less.<br />- **11046**: An add-on code for each additional 20 sq. cm of muscle/fascia, to be used with CPT 11043.<br /><br />Additionally, the document provides reimbursement values for these CPT codes according to the CMS National Non-Facility Payment Amount for 2022:<br /><br />- **11042**: $133.93 (1.01 wRVU)<br />- **11045**: $41.87 (0.50 wRVU)<br />- **11043**: $239.48 (2.70 wRVU)<br />- **11046**: $75.44 (1.03 wRVU)<br /><br />Key coding instruction states that for a single wound, the depth should be reported by the deepest level of tissue removed. If multiple wounds are treated, sum the surface area of wounds at the same depth, but do not mix surface areas from different depths.<br /><br />For further questions or information, providers can contact the Home Centered Care Institute using the provided contact details.

Keywords

HBPC

CPT codes

debridement services

wound management

excisional debridement

11042

11045

11043

11046

reimbursement values