ED Coding and Reimbursement Alert

Question: A patient with a pressure ulcer on his shoulder blades reported to the ED, and the physician removed devitalized tissue from the ulcer area. How should I report the service?

Minnesota Subscriber

Answer: You-ll need to check the operative notes for the size of the excision area.

Option 1: If the total area removed is 20 square centimeters or less, 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). Also, include 707.02 (Decubitus ulcer; upper back) to represent the patient's pressure ulcer.

Option 2: I f the total removal area exceeded 20 square centimeters, report 97598 (... total wound[s] surface area greater than 20 square centimeters) with 707.02 attached instead.