Wiki 97602 - I need some advice

[tarafarmer]

Hi, I need some advice. One of our offices has been billing 97602 for debridement. As I looked over this code, it looks as if this is for theropy or specialty prace. I have never used this code. Could someone give me a little more information regarding this code? I was looking at using 11000 instead. Thank you.

 

[RebeccaWoodward*]

The purpose of adding codes 97601 and 97602 was to describe how to report interventions associated with active wound care management, as performed by non-physician health care providers (eg, physical therapists, occupational therapists and enterostomal nurses). The active wound care procedures of selective and non-selective debridement techniques are performed to promote healing by removing devitalized or necrotic tissue from the wound bed. The choice of technique used to remove the targeted necrotic tissue is made by the health care provider based on an assessment of the wound and which method would be most effective given the patient's tolerance for the technique, size of the wound debridement area, and condition of the wound bed and surrounding tissues.

These interventions associated with active wound care management are a critical part of the care of patients with wounds. Both selective and non-selective debridement techniques are performed in a wide range of medical settings, are considered non-surgical and therefore do not require the use of general anesthesia. The scope of these services and the context in which these services are delivered are inherently different from surgical debridement procedures.

Surgical debridement procedures, as performed by physicians, could require complex, surgical procedures and often require the use of general anesthesia. Previous to CPT 2001, the only codes that referred to debridement were found in the surgery section of the CPT book (11040-11044). In CPT 2002, codes 97601 and 97602 are used to describe selective and non-selective debridement performed without the use of anesthesia and should not be reported in addition to codes 11040-11044.

 

[halebill]

This is excellent information from Rebecca, as always. Tara, I believe you are auditing for urgent care centers in South Carolina? I have checked the SC BCBS and Medicare fee schedules for code 97602, and it is not on either. I believe it would be best to stick to debridement codes 11040-11044.


Bill Hale, CPC