How To Use cpt 11046

cpt 11046 describes the additional debridement of muscle and/or fascia, including the epidermis, dermis, and subcutaneous tissue, if performed, in increments of 20 square centimeters or part thereof. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11046.

1. What is cpt 11046?

cpt 11046 is a code used to describe the additional debridement of muscle and/or fascia, including the epidermis, dermis, and subcutaneous tissue, if performed, in increments of 20 square centimeters or part thereof. This code is used when a healthcare provider removes dead or damaged tissue from a larger area during the same session as the primary debridement procedure.

2. Official Description

The official description of cpt 11046 is: ‘Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed) each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)’

3. Procedure

1. The healthcare provider assesses the patient’s condition and determines the need for debridement of muscle and/or fascia.
2. If the primary debridement procedure is performed, the provider may identify the need for additional debridement in increments of 20 square centimeters or part thereof.
3. The provider uses surgical instruments, such as a scalpel or scissors, to remove the dead or damaged tissue from the muscle and/or fascia, as well as the subcutaneous tissue layer, epidermis, and dermis if needed.
4. The provider continues the debridement until healthy tissue is visible.
5. The wound may be closed in layers or left to heal by secondary intention.
6. cpt 11046 is used in conjunction with the primary debridement procedure code, cpt 11043.

4. Qualifying circumstances

cpt 11046 is used when there is a need for additional debridement of muscle and/or fascia, including the epidermis, dermis, and subcutaneous tissue, in increments of 20 square centimeters or part thereof. This code is used when the primary debridement procedure (cpt 11043) is performed, and the provider identifies the need for additional debridement during the same session.

5. When to use cpt code 11046

cpt 11046 should be used when the healthcare provider performs additional debridement of muscle and/or fascia, including the epidermis, dermis, and subcutaneous tissue, in increments of 20 square centimeters or part thereof, during the same session as the primary debridement procedure (cpt 11043). This code should only be used when the additional debridement is necessary and performed.

6. Documentation requirements

To support a claim for cpt 11046, the healthcare provider must document the following information:

• The primary debridement procedure code (cpt 11043)
• The size of the additional debridement area in square centimeters
• The specific tissues debrided (muscle and/or fascia, epidermis, dermis, subcutaneous tissue)
• The method used for debridement (surgical instruments)
• The closure method (layers or secondary intention)
• The date and start time of the procedure
• The provider’s signature

7. Billing guidelines

When billing for cpt 11046, ensure that the primary debridement procedure (cpt 11043) is also reported. cpt 11046 is an add-on code and should not be reported without an appropriate primary code. There are no specific guidelines regarding reporting cpt 11046 with other codes.

8. Historical information

cpt 11046 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Similar codes to cpt 11046

Five similar codes to cpt 11046 include:

• cpt 11043: Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed) initial 20 sq cm or less
• cpt 11044: Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed) each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
• cpt 11045: Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less
• cpt 11047: Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
• cpt 11042: Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less

9. Examples

1. A healthcare provider performs a primary debridement procedure (cpt 11043) on a patient’s leg, removing 15 square centimeters of dead tissue. During the same session, the provider identifies an additional 25 square centimeters of tissue that requires debridement. cpt 11046 is reported for the additional debridement.
2. A patient undergoes a primary debridement procedure (cpt 11043) on their arm, removing 10 square centimeters of damaged tissue. The provider then performs an additional debridement of 30 square centimeters during the same session. cpt 11046 is reported for the additional debridement.
3. A healthcare provider performs a primary debridement procedure (cpt 11043) on a patient’s back, removing 18 square centimeters of necrotic tissue. The provider identifies an additional 22 square centimeters of tissue that requires debridement and performs the additional debridement during the same session. cpt 11046 is reported for the additional debridement.
4. A patient undergoes a primary debridement procedure (cpt 11043) on their abdomen, removing 12 square centimeters of damaged tissue. The provider then performs an additional debridement of 28 square centimeters during the same session. cpt 11046 is reported for the additional debridement.