2025 CPT code 11042
(Active) Effective Date: N/A Revision Date: N/A Surgery - Debridement Procedures on the Skin Surgery Feed
Debridement of subcutaneous tissue (includes epidermis and dermis if performed); first 20 sq cm or less.
Modifiers 25 (E/M service), 59 (distinct procedural service), 77 (repeat procedure by another physician), 78 (unplanned return to OR), and others may be applicable depending on the circumstances. Consult the CPT manual for specific modifier guidance.
Medical necessity for debridement is established by the presence of necrotic, devitalized, or infected tissue that impedes wound healing.The procedure is considered medically necessary to prevent infection, promote healing, and improve the patient's overall health.
The physician is responsible for pre-operative preparation, administration of anesthesia (if needed), surgical debridement using appropriate instruments, hemostasis, application of antibiotics, and wound dressing. Post-operative care is typically included in the global package.
In simple words: This code represents the surgical removal of dead or infected tissue from just beneath the skin, covering an area no larger than about 3 square inches. The doctor cleans the area, removes the unhealthy tissue using instruments, stops any bleeding, applies medicine, and covers the wound.
CPT code 11042 describes the surgical debridement of subcutaneous tissue, encompassing the epidermis and dermis if involved, up to a maximum area of 20 square centimeters.This procedure involves the removal of necrotic, devitalized, or infected tissue to promote wound healing.The code is applicable to various wound types, including injuries, infections, chronic ulcers, and pressure ulcers.It does not include debridement of bone, muscle, or fascia; separate codes apply for those instances. The procedure includes preparation, anesthesia (if necessary), cleansing, and removal of nonviable tissue until viable bleeding tissue is observed. Hemostasis, antibiotic application, and wound dressing are also part of this procedure.
Example 1: A patient presents with a 15 sq cm diabetic foot ulcer with significant necrotic subcutaneous tissue. The physician performs debridement, removing the devitalized tissue to promote healing., A patient sustains a traumatic leg wound with an area of 18 sq cm of subcutaneous tissue damage requiring surgical debridement.The physician removes the necrotic tissue and prepares the wound for healing., A patient presents with a pressure ulcer on their sacrum measuring 20 sq cm.The physician performs sharp debridement to remove the necrotic tissue, improving the wound bed.
Detailed medical history including the cause and duration of the wound.Precise measurements of the wound dimensions (length, width, depth).Documentation of the type and amount of tissue debrided (e.g., subcutaneous, epidermis, dermis). Photographs of the wound before and after the procedure.Description of the instruments used. Note of the type of dressing applied.Post-operative instructions given to the patient.
** Accurate documentation is critical for proper reimbursement.The code selection should reflect the deepest level of tissue debrided and the total surface area.This code does not encompass non-surgical wound care.
- Revenue Code: P5A (AMBULATORY PROCEDURES - SKIN)
- RVU: This information requires access to a specific payer's fee schedule or a commercial pricing database. RVUs vary based on geographic location and payer.
- Global Days: The global period for this procedure is generally considered to be included in the procedure itself, meaning no additional payment is typically made for post-operative care within a defined period.
- Payment Status: Active
- Modifier TC rule: Technical Component (TC) modifiers are not typically applicable to this code as it represents the entire procedure.
- Fee Schedule: Historical fee schedule data is not provided here and would be dependent on specific payer and year.
- Specialties:General Surgery, Plastic Surgery, Wound Care, Podiatry (for foot ulcers), and other specialties treating wounds.
- Place of Service:Office, Ambulatory Surgical Center (ASC), Hospital (Inpatient or Outpatient), other locations as appropriate for the setting and procedure.