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  1. Can we bill Graft along with other procedure, say for example CPT 17250 or should we send a separate claim for Graft and a separate claim for other procedures.
  2. Can we bill nail debridement CPT 11042 / 11043 along with Graft, if the service is done on wounds/diagnoses unrelated to the wound that received the graft.
  3. Can we use modifier 59 for CPT 11042 / 11043
E
EmilyC
Typically debridement (11042-11046) is included in graft placement when performed on the same wound.

If the patient had multiple wounds and the physician debrided one wound, but placed a graft on a separate wound, you can bill for both the debridement and the graft with a mod 59, but the note must clearly state that wound A was debrided and wound B had a graft placement.
E
EmilyC
There are no CCI edits saying you can't bill 17250 w/graft, but you can't use with debridement. I would also look through Medicare's policy manual. It comes up if you google "Medicare wound care guidelines" just to be sure.
We give IV chemotherapy infusions and shots in our office. Occasionally a patient will react to this, and we put put our AED paddles on them just in case, occasionally have to start CPR. How do we bill for this? The AED paddles cost approximately $250 a pair. Usually EMT gets there with in 15 minutes and takes over care and takes them to the hospital within another 15 min. Thoughts?
My OT want to charge cpt 96156 from what I am reading that only healthcare professionals who may report E/M services or preventive medicine services can report this. Am I on the right track?
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