A newly introduced coding concept related to the reporting of wound débridements is also significant. The code range 11040–11044 has been completely revised; the major changes are as follows:
- CPT codes 11040 and 11041 have been eliminated; they are replaced by CPT codes 97597 and 97598 as appropriate for débridement of dermal and epidermal skin layers. Check the manual for the new definitions.
- The reporting of wound débridement is now based on the depth of tissue débridement and the size of the wound in square centimeters.
- Surgeons must “sum” the surface areas of multiple wounds of the same depth; each wound should be reported separately if the tissue débridements are of different depths.
- New add-on codes (11045, 11046, and 11047 for each additional 20 sq cm, based on the depth of the debridement) were introduced
As a result of these changes, CPT code 11042 now reads, “Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less.” The associated new add-on code 11045 should be reported for each additional 20 sq cm or part thereof. Additionally, the surgeon’s documentation must include the size of the wound(s) (eg, 4 cm x 5cm) and the depth of tissue débridement for each individual wound for which the procedure is performed. The guidelines for the repair (closure) codes were revised related to the definition of a complex repair, and the definition of débridement and services included have been added to the repair codes. Surgeons performing complex repairs are now allowed to report this work separately when done in conjunction with débridement codes, excision of benign or malignant lesion codes, excisional preparation of a wound bed codes, or débridement of an open fracture or open dislocation codes. Changes to the skin substitutes guidelines reinforce the range of codes that are “skin substitutes” and include specific instructions for using these codes. As an example, skin substitute codes should not be reported when the products are used as mesh or for internal reconstructive work such as a rotator cuff repair. These codes should only be reported when the product is used as a skin substitute.