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Answer: Codes 11040-11044 (debridement; skin) are more appropriate in the ED than 97601. The new 97601 (removal of devitalized tissue from wound; selective debridement, without anesthesia [i.e., 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) series of codes seems to be meant for facilities such as wound-care clinics. One indication that suggests not using the codes in the ED is that the Federal Register doesn't assign them for an APC but has them billed under the rehabilitation schedule.
However, you should separately bill codes 11040-11044 if the procedures they represent are separately provided. These codes are applicable to skin, subcutaneous tissue, muscle, bone or nail avulsion and describe treatment to grossly contaminated injuries that require prolonged cleansing. For example, a patient presents to the ED with a 24-hour-old wound to the knee that is into deep-tissue structures. It is deeply ingrained and embedded, with dirt and grime virtually tattooed into the tissues, exposing the joint capsule. Debridement is performed with removal of devitalized and contaminated tissues. One small suture is used to bring the wound edges together but not close the wound. The wound is left open for drainage and wrapped. |
