Do Not Overstate Debridement If Yourre A Surgical Coder

Tip: This encounter covers topical applications and patient care instruction apart from removing devitalized tissue

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Question: When the surgeon carries out a wound VAC or for that matter cleans a wound by scraping with a sharp curette (not excising tissue), is it right to use a debridement code or should we go for an active wound care management code from the range 97597-97606?

Answer: Physicians normally use the debridement codes (11000-11001, debridement of extensive eczematous or infected skin; or 11004-11005, Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; ) for debridement by any method.

Without doubt these codes most closely describe wound debridement by sharp curettement. You should only report wound care management codes like 97605-97606 (Negative pressure wound therapy [e.g., vacuum assisted drainage collection], including topical application[s], wound assessment, and instruction[s] for ongoing care, per session; ) for a therapeutic service that covers more than simple wound debridement.

According to CPT instruction, these medical coders call for "direct (one-on-one) patient contact" to debride the site and "promote healing." As the definition points to, the encounter covers topical applications and patient care instruction in addition to doing away devitalized tissue.

AMA weighs in: According to June 2005 CPT Assistant, "Codes in the active wound care management series provide a mechanism for reporting interventions associated with active wound care as carried out by licensed non-physician professionals. For wound debridement carried out by physicians, see codes 11040-11044. " To put it differently, active wound care management codes describe wound therapy, and not just surgical debridement.

Even if your surgeon places a wound Vacuum Assisted Closure (VAC) during surgery, see to it that payers often bundle the service. Payers may think about placing the wound VAC to be little more than fancy "bandages." Check with your payers to ensure you follow their instruction so that you get maximum profit for this service.

by: Nancy Rose

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