I have a patient with diabetic peripheral neuropathy and foot ulcers. I have been debriding the ulcers every two weeks, and we have billed out CPT 11042. Cigna has denied our latest two claims and the EOB says, “Procedure code is invalid for DOS and global.” There is no global for CPT 11042 and there should not be a procedure code invalid for any DOS with these claims. Any thoughts on what to do next?
Screen all employees at the time of hiring and every month for the List of Exclude Individuals/Entities. A current employee can end up on the exclusions list at any time so it is important to regularly check to see if they are on the exclusions list.