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Billing and Coding Guidelines for Wound Care

Billing and Coding Guidelines for Wound Care LCD ID L34587 Billing Guidelines Wound Care (CPT Codes 97597, 97598 and 11042-11047) 1. Active Wound care procedures are performed to remove devitalized and/or necrotic tissue to promote healing. Debridement is the removal of foreign material and/or devitalized or contaminated tissue from or adjacent to a traumatic or infected Wound until surrounding healthy tissue is exposed. These services are billed when an extensive cleaning of a Wound is needed prior to the application of primary dressings or skin substitutes placed over or onto a Wound that is attached with secondary dressings. 2. Typically bill CPT 97597 and/or CPT 97598 for recurrent Wound debridements when medically reasonable and necessary.

related to a physician service billed to the Medicare contractor are not subject to the consolidated billing requirements. 10. CPT code 97602 has been assigned a status indicator "B" in the Medicare Physician Fee Schedule Database (MPFSDB), meaning that it is not separately payable under Medicare. 11. Documentation must support the HCPCS being ...

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