Podiatry Coding & Billing Alert

Question: Being new to podiatry coding, I’m confused as to what active wound care management means exactly. Can you tell me what it is and what codes I can report when my podiatrist performs these procedures?

Illinois Subscriber

Answer: Active wound care management refers to any procedures that are performed to remove devitalized and/or necrotic tissue to promote healing. These procedures often involve debridement, which is the process of removing dead tissue, foreign material, or infected matter from a wound using processes such as sharp excision or high-pressure waterjet; or non-selective processes such as abrasion or enzyme treatments.

In terms of coding, there are several codes that you might use on claims for active wound care management.

Remember: Active wound care management involves the epidermis and dermis only.

“There are two types of non-excisional debridement, selective and non-selective. Selective debridement — 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] and its add-on code +97598 [Debridement…each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure] — entail the precise removal of targeted non-viable tissue, a procedure requiring clear documentation including the specific areas addressed, the instruments employed — e.g., scalpel, forceps — and a comprehensive wound assessment. On the other hand, non-selective debridement — 97602 [Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session] — involves the gradual removal of non-viable tissue, usually not performed by a physician. Proper documentation for non-selective debridement should encompass techniques used,” says Jennifer McNamara, CPC, CCS, CRC, CPMA, CDEO, COSC, CGSC, COPC, director of healthcare training and practice support at Healthcare Inspired LLC in Bella Vista, Arkansas.

Below are a few common podiatry-related conditions which may require you to code for active wound care management:

• Diabetic foot ulcers
• Pressure ulcers
• Venous statis ulcers
• Traumatic foot wounds.