Reader Question: Nurses in Wound Care Centers

Question: Can nurses who are specially trained perform wound debridements, and is this billable using the usual CPT debridement codes? Also, can an evaluation and management (E/M) code be used to bill for services provided by the clinic to a patient when the physician did not participate in the services provided?

Florida Subscriber

Answer: Yes, nurses can perform wound debridements, and for 2001 there are new codes with clearer direction as to who may use them. They are 97601 (removal of devitalized tissue from wound; selective debridement, without anesthesia [e.g., high pressure waterjet, sharp selective debridement with scissors, scalpel and tweezers], including topical application[s], wound assessment, and instruction[s] for ongoing care, per session) and 97602 (... non-selective debridement, without anesthesia [e.g., wet-to-moist dressings, enzymatic, abrasion], including topical application[s], wound assessment, and instruction[s] for ongoing care, per session). The two new codes are to be reported by nonphysician professionals (e.g., physician assistants, nurse practitioners, physical therapists, enterostomal therapy nurses and wound care nurses).

A clinic visit E/M could be coded in this scenario if there is a medically necessary examination done during the same encounter. Be sure to add modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) if you use an E/M and procedure code on the same day if you feel they are both justified for payment. If no significant examination was done, only the debridement, then you would just charge and code the procedure.

- Published on 2001-01-01