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July 2016

Here’s what you need to know about surgical debridement and routine foot care coding

Debridement is the surgical removal of infected, weakened or pathological tissue, as well as foreign material. Postoperative complications, such as a deep wound gap or wound infection, may require surgical debridement.

The patient’s medical records must document both the need for and performance of these services. You can use the following procedure codes to report the appropriate description and level of wound debridement:

*11000
*11001
*11042
*11043
*11044
*97597

Note: Codes *11040 and *11041 have been discontinued.

Don't use the codes above when reporting:

  • Postoperative debridement of incisions, which involve normal exfoliation of the superficial layers of the skin
  • Procedures using chemical, cryotherapy, laser or other destruction where there's expected exfoliation or drainage secondary to the procedure performed

Routine foot care guidelines

Debridement for routine foot growths — corns, calluses — refers to the paring, curettement, shaving, cutting or sharp dissection of nonpathological tissue, which isn't associated with a wound, ulceration or infected tissue.
Routine foot care is the routine treatment and cutting of corns, calluses and nail treatment. It includes paring, cutting, debridement and curettement of:

  • Corns
  • Calluses
  • Nails
  • Benign lesions or other thickened skin
  • Toenails infected with a fungus

Blue Cross Blue Shield of Michigan doesn't cover routine foot care, except for the following groups:

  • Kmart
  • Michigan Education Special Services Association, or MESSA
  • State of Michigan

None of the information included in this article is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with applicable state and federal laws and regulations.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.