2025 CPT code 11011
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Debridement of skin, subcutaneous tissue, muscle fascia, and muscle in open fracture/dislocation, including foreign material removal.
Modifiers may be necessary depending on the circumstances and the payer's guidelines.For example, modifier 59 might be applied to indicate a distinct procedural service in cases of multiple wounds or procedures.
Medical necessity is established by the presence of an open fracture or open dislocation with associated necrotic tissue, foreign bodies, or infection that require surgical debridement to prevent further complications, promote healing, and preserve limb function.Clinical judgement is key.
The physician's responsibilities include pre-operative preparation, anesthesia administration (if applicable), meticulous surgical debridement of the wound, exploration of adjacent tissues, irrigation, and possibly wound closure or stabilization techniques depending on the patient's condition.Post-operative care is separately reported.
In simple words: The doctor cleans and removes dead or damaged tissue, along with any foreign objects, from a wound involving a broken bone that has broken through the skin, or a joint that is out of place. This includes cleaning the wound, removing dead tissue and foreign material with surgical tools, and rinsing the area.Other steps might be needed, but those would be billed separately.
This CPT code encompasses the surgical debridement of necrotic tissue and foreign material from the skin, subcutaneous tissues, muscle fascia, and muscle surrounding an open fracture and/or open dislocation.The procedure involves meticulous wound cleansing, removal of necrotic tissue and foreign bodies using instruments like forceps and scalpels, and irrigation of the affected tissue layers. Examination of adjacent soft tissues (tendons and ligaments) may also be included. Subsequent procedures, such as fracture/dislocation reduction or wound closure, are separately reported.
Example 1: A patient presents with an open tibia fracture after a motorcycle accident. The surgeon performs debridement of the wound, removing necrotic tissue, bone fragments, and road debris. This procedure is coded as 11011., A patient sustains an open dislocation of the elbow joint, with significant soft tissue damage and contamination.The physician performs debridement of the wound, addressing necrotic tissue and foreign bodies, including irrigation and wound exploration. This is coded as 11011., A patient with a chronic diabetic foot ulcer undergoes debridement of necrotic tissue, involving the skin, subcutaneous tissue, and muscle fascia of the ulcer. This is coded 11011 provided the debridement is associated with an open fracture or open dislocation; otherwise a different code would be used.
Detailed operative report including description of the extent of debridement, tissues involved, foreign materials removed, irrigation performed, and any other relevant details. Preoperative and postoperative clinical findings should be documented along with images (if available).Any additional procedures performed should also be documented.
** Accurate coding requires a thorough understanding of the extent of tissue involvement and the presence of foreign material.Always refer to the latest CPT guidelines and payer-specific instructions.
- Revenue Code: P5A (AMBULATORY PROCEDURES - SKIN)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Orthopedic Surgery, Trauma Surgery, Plastic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center