Question: The surgeon saw a patient to treat a pressure ulcer on her lower back. The physician removed devitalized tissue from the ulcer using a waterjet and forceps. The surface area of the wound was 13 sq cm. Can we report a code for the waterjet in addition to the debridement code?
Montana Subscriber
Answer: No, you cannot report the waterjet separately because the debridement codes include the waterjet use. On the claim, you should report the following:
• the appropriate code from the 11040-11044 series (Debridement ... APCs 0015, 0016 and 0682), depending on the documented depth of the debridement
• 707.03 (Decubitus ulcer; lower back) linked to the debridement code for the pressure ulcer.
You may be tempted to report 97597 (Removal of devitalized tissue from wound[s], selective debridement, without anesthesia [e.g., high-pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps], with or without topical application[s], wound assessment, and instruction[s] for ongoing care, may include use of a whirlpool, per session; total wound[s] surface area less than or equal to 20 square centimeters: APC 0015) for the debridement, but CPT designed this code primarily for nonphysician practitioners.
Although physicians may use 97597, they would usually call on the skin debridement codes (11040-11044), particularly if an anesthetic is involved. Moreover, payers generally recognize and reimburse debridement codes more consistently in the physician setting.
