Eli's Rehab Report

Question: We provide wound care services in my outpatient rehab clinic. Can we use any other charges in conjunction with debridement charges, or is debridement an all-inclusive charge that covers the bandage and dressing change, too? The codes we use for debridement are 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) and 97598 (...total wound(s) surface area greater than 20 square centimeters).

-- New Jersey subscriber

Answer: Wound care's a frustrating area because many codes are not reimbursable, and the work is costly and timeconsuming.  The good news is that the codes you mentioned -- selective debridement -- are reimbursed by Medicare and other major payers. The bad news is that the charge for these codes is "all inclusive." So you can't charge separately for the bandage and dressing change. You can, however, read about some creative ways to make your wound care business more productive and profitable in Physical Medicine & Rehab Coding Alert, Vol. 10, No. 8. As for your other question, you may bill only one unit per session for the selective debridement codes because these are untimed codes. Insurance payers, including Medicare, allow you to bill multiple units only for timed codes -- those that specify a time amount in the code descriptor.