You can't bill the 11042 twice for one DOS. You add up the sq. cm debrided, for BOTH toes, and since that is 20 sq. cm's or less, you bill the 11042 once. The 11045 is an add on code, and would only be used if you did more than 20 sq. cm's for all areas debrided. You don't use the LT/RT modifiers for 11042, because skin has no laterality, it is a continuous organ.