Outpatient Facility Coding Alert

Published on Tue Mar 31, 2015 PDF

Question: A patient was seen for stage 2 wound care of ulcers for both right heel and left shin.  Can we use the wound care code 97602 with modifier 50?

Iowa Subscriber

Answer: CPT® code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less) is the correct choice. Also, for multiple wounds, sum the surface area of those wounds that are at the same depth, but not those for different depths.  Note that Modifier 50 (Bilateral procedure) cannot be billed with this code.

You can report code 97602 (Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia [e.g., wet-to-moist dressings, enzymatic, abrasion], including topical application[s], wound assessment, and instruction[s] for ongoing care, per session) for removal of devitalized tissue from wounds when the surgeon performs non-selective debridement (chemical method, hydrogen peroxide, iodine, Pulsed lavage method etc.).

Also: CPT® codes from wound debridement series (11042 - 11047) can be used if the physician completes active debridement with surgical instruments (forceps and scissors to remove infected or dead tissue material from the wound). Your code selection will depend on the depth of the tissue removed, such as debridement up to the level of subcutaneous tissue.