General Surgery Coding Alert

Question: The surgeon saw a patient for treatment of 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 bundle waterjet use into the service. On the claim, you should:

- report the appropriate code from the 11040-11044 series (Debridement ...), depending on the documented depth of the debridement.

- link 707.03 (Decubitus ulcer; lower back) 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) for the debridement, but CPT designed this code for use by nonphysician practitioners. Although surgeons are not prohibited from using 97597, they would usually call on the skin debridement codes (11040-11044), which are better and more consistently paid.