Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Debridement to bone documented but bone pathology/exposure not clearly described
Occasional11047 (debridement bone, first 20 sq cm) requires debridement reaching and including bone - most extensive depth. Denied when bone visible but not debrided, when only soft tissue debrided to bone level, or when osteomyelitis/necrotic bone not documented. Highest debridement reimbursement - requires exceptional documentation.
Common Causes
- • Bone exposed after debridement but bone itself not debrided - should be 11043 (fascia/muscle)
- • No documentation of necrotic/infected bone requiring removal
- • Wound probe to bone documented but no bone debridement performed
Resolution Strategy
Document bone debridement: 'Chronic osteomyelitis right foot with exposed calcaneus. Sharp debridement performed removing necrotic soft tissue and infected bone. Rongeur used to excise necrotic bone from calcaneus, healthy bleeding bone margins achieved. Approximately 15 sq cm bone surface debrided. Wound irrigated, packed with antibiotic beads.' Must show: necrotic/infected bone identified, bone physically debrided (rongeur, curette), healthy bone margins achieved, size documented. If bone exposed but not debrided, use 11043 for soft tissue debridement to bone level.
Relative Value Units (RVUs)
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Clinical Information
When to Use
For each additional 20 sq cm of bone debridement beyond the first 20 sq cm coded with 11044, including all overlying tissue layers
Common Scenarios
Documentation Requirements
- Total area of bone debridement
- Anatomic locations specified
- All tissue layers removed documented
- Bone condition and extent of infection/necrosis
- Medical necessity for extensive debridement
Coding Guidelines
Common Modifiers
Bundling Rules
- Must report with 11044
- List separately add-on code
- Report per 20 sq cm beyond first
Exclusions
- Cannot bill without 11044
- First 20 sq cm uses 11044
- Muscle only uses 11046
Coding Notes
Clinical scenarios
- Total area of bone debridement
- Anatomic locations specified
- All tissue layers removed documented
- Total area of bone debridement
- Anatomic locations specified
- All tissue layers removed documented
- Total area of bone debridement
- Anatomic locations specified
- All tissue layers removed documented
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Code Details
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Ask a QuestionFrequently Asked Questions
CPT 11047 is the billing code for "Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof". For each additional 20 sq cm of bone debridement beyond the first 20 sq cm coded with 11044, including all overlying tissue layers
Medicare pays approximately $117.42 for CPT 11047 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.
CPT 11047 has a total RVU of 2.86, broken down as: Work RVU 1.28, Practice Expense RVU 1.45, and Malpractice RVU 0.13. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 11047 is "Debridement to bone documented but bone pathology/exposure not clearly described". 11047 (debridement bone, first 20 sq cm) requires debridement reaching and including bone - most extensive depth. Denied when bone visible but not debrided, when only soft tissue debrided to bone level, or when osteomyelitis/necrotic bone not documented. Highest debridement reimbursement - requires exceptional documentation. Common causes include: Bone exposed after debridement but bone itself not debrided - should be 11043 (fascia/muscle); No documentation of necrotic/infected bone requiring removal. Appeal success rate is approximately 40-60%.
Key documentation requirements for CPT 11047 include: Total area of bone debridement; Anatomic locations specified; All tissue layers removed documented; Bone condition and extent of infection/necrosis. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 11047: Must report with 11044. List separately add-on code Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 11047 include: 59 (Distinct procedural service if applicable). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 11047 is 15-20 minutes per additional 20 sq cm. Time-based codes require documentation of the actual time spent providing the service.