CPT code 11042 can be reported for debridement of up to 20 sq cm or less of subcutaneous tissue, epidermis, and dermis (if performed).
What Is CPT Code 11042?
CPT 11042 can be used for debridement (the removal of dead, damaged, or infected tissue from a wound) of subcutaneous tissue (layer of tissue that lies underneath the skin) and may be used for the first 20 sq cm or less.
CPT 11042 includes the removal of both the epidermis and dermis (the top two layers of the skin) if those layers are also damaged or infected and need to be removed.
The description specifies that the debridement procedure should be limited to the first 20 square centimeters (cm²) or less of the affected tissue.
The CPT book defines CPT code 11042 as: “Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less.”
The provider performs debridement using surgical instruments to remove dead and infected tissue from the skin down to the subcutaneous layer, including the epidermis and dermis, within an area of up to 20 cm2.
After prepping and anesthetizing the patient, the provider thoroughly cleans the wound and uses forceps and scissors to remove dead tissue.
Debridement is continued until only viable tissue remains, and the provider then controls bleeding, applies antibiotics, and dresses the wound.
How To Use CPT 11042
CPT code 11042 can only be billed for the debridement of the first 20 cm2 subcutaneous tissue, including removing any dead or infected tissue from this layer.
The add-on code CPT 11045 can be used for each additional 20 cm2 body surface debrided.
If the debridement procedure also includes the removal of muscle and/or fascia and the subcutaneous tissue, dermis, and epidermis, you may use CPT code 11043.
Report CPT 11044 if debridement includes bone as well.
You may use CPT 97597 and CPT 97598 for wound care management on the skin’s upper layer(s) (dermis and epidermis).