General Surgery Coding Alert

Do burn debridement procedures have their own codes?

Removing unhealthy or dead tissue from a wound is crucial to helping the wound heal properly. This process is known as debridement, and reporting the procedures can be complicated even for the most experienced surgery coders.

Gena Cornett, CPC, CPB, CPCO, CRCR, RCMS, CPB-I, vice president of billing and revenue management at Healogics, LLC, provided attendees with valuable information about coding debridement procedures during her “From Wounds to Wins: Expert Tips for Accurate Coding” session at AAPC’s HEALTHCON Regional 2025.

Read on to get answers to five frequently asked debridement questions.

Get to Know Debridement Procedures

Question: What are the different types of debridement procedures?

Answer: Cornett explained that physicians will perform two types of debridement — surgical or active wound management. “Surgical debridement is the removal of the deeper layers of tissue, fat, muscle, fascia, and bone,” Cornett said.

Surgical debridement codes can be categorized by the tissue level reached, such as:

• Subcutaneous tissue
  • 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less)
  • +11045 (… each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure))
• Muscle or fascia
  • 11043 (Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less)
  • +11046 (… each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure))
• Bone
  • 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less)
  • +11047 (… each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure))

On the other hand, active wound management is the removal of devitalized or necrotic tissue, foreign material, and other debris to encourage healing and help reduce the risk of complications. “We sometimes call active wound management open or selective wound debridement. This includes our disposable negative pressure therapy, our negative pressure therapy, our MIST^® therapy, and then our non-selective debridement.”

Examples of active wound care management codes include:

• 97597 (Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less)
• +97598 (… each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure))
• 97602 (Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session)
• 97605 (Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters)
• 97606 (… total wound(s) surface area greater than 50 square centimeters)

“When we’re coding a wound debridement, whether it’s a selective open wound debridement or an excisional debridement, we’re going to look at the depth and we’re going to choose our code based on the deepest level of the tissue removed,” Cornett said.

Know How to Select Your Debridement Code

Question: What factors into debridement code selection?

Answer: The two main factors that come into play when determining the debridement code to report the surgeon’s services are the deepest level of tissue removed and the surface area of the wound. As mentioned above, the debridement codes are separated by the tissue level.

Next, the physician needs to calculate and document the surface area of the wound when they debride the injury. The wound may be measured as length by width or as an ellipse. “You might have noticed that most wounds aren’t in a perfect rectangle or square. They’re usually round and some of them take all kinds of odd shapes,” Cornett pointed out.

Point Out That Percentages Won’t Suffice in the Documentation

Question: Can we code the entire wound if less than the wound was debrided?

Answer: No, you will only code the actual area of the wound that the surgeon debrided, even if that area is less than the size of the wound. “Sometimes the physician doesn’t have to take everything. There might be good granulation tissue in part of the wound, and they just want to take out the necrotic tissue,” Cornett explained.

The provider needs to measure what they actually debrided in values you need to report the correct code. For example, the surgeon can’t document that they debrided 80 percent of the wound. Instead, they should write that they debrided 16 sq cm of a 20 sq cm wound.

Avoid Surgical Codes for Burn Debridement Services

Question: Should we use surgical debridement codes for burn debridements?

Answer: No, you will not use surgical debridement codes for burn debridement procedures. The burn debridement codes are as follows:

• 16020 (Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area))
• 16025 (… medium (eg, whole face or whole extremity, or 5% to 10% total body surface area))
• 16030 (… large (eg, more than 1 extremity, or greater than 10% total body surface area))

The codes listed here are for dressings and debridement, so even if the provider is changing the dressing on the burn, you can still report these burn debridement codes.

Add Areas for Debridement of Multiple Wounds

Question: How do we report debridement procedures of multiple wounds?

Answer: You’ll report debridement procedures for multiple wounds by grouping like depths together and adding the treated wound areas. For example, if the provider debrides two wounds on the patient’s calf down to the subcutaneous level, then you’ll add the debrided surface area of the two wounds to determine your code.

“We’re going to add like depths together. If we debrided the wounds to different levels, then we’re going to pick two codes and use the appropriate modifier,” Cornett explained.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC