General Surgery Coding Alert

Question: We have a case in which the surgeon documents sharp selective debridement with scissors for an open wound involving the epidermis and dermis, including dressing the wound and providing wound-care instruction. Should we use the debridement codes or active wound care codes?

South Carolina Subscriber

Answer: You should report the following code(s) depending on the surface area involved:

• 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))

The other codes you mention include the following, with each add-on code for additional area beyond the initial 20 sq cm:

• 11042, +11045 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); …)
• 11043, +11046 (Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); …)
• 11044, +11047 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); …)

Notice that each code in the range 11042-+11047 involves debridement of tissue below the dermis and epidermis. That’s why CPT^® includes a text note with these codes, “For debridement of skin (i.e., epidermis and/or dermis only) see 97597, +97598.”