Debridement – Claim Documentation Requirements

Code Code Description Documentation Required
11043 Debridement, muscle and/or fascia (includes epidermis, dermis and subcutaneous tissue if performed); first 20 sq cm or less Operative report
11044 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia if performed); first 20 sq cm or less Operative report

In addition, HMSA may require submission of clinical records before or after payment of claims for the purpose of investigating potential fraudulent, abusive or other inappropriate billing practices, but only as long as there is a reasonable basis for believing such investigation is warranted.


Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.