Podiatry Coding & Billing Alert

Question: Can registered nurses (RNs) perform/bill for a debridement (CPT^® 97597)?

AAPC Forum Participant

Answer: Medicare and payers following Medicare rules do not allow RNs to perform 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). Per Medicare local coverage article A53296, “A physician, NPP [non-physician practitioner] or therapist acting within their scope of practice and licensure may provide debridement services” billed with 97597 (www.cms.gov/medicare-coverage-database/view/article. aspx?articleid=53296).

However, Medicare policy goes on to note that “hospital staff acting within their scope of practice and/or licensure” and “staff providing therapy services incident-to the physician treatment plan … may provide wound care, including debridement services, incident-to the services of a physician/NPP.”