Wiki 97605 in OR with another surgery

[KJenkins588]

Has anyone found that Medicare will deny a wound vac at the time of another surgery if done in the OR? I have a tiny note from a previous coder that used to work where I do and when I asked her about it she is unsure where she found this information or if it was just a bunch of denials that she was getting and just noticing that they won't pay for it. Any help would be appreciated...

Thanks,
Kayla

 

[FTessaBartels]

97605 bundles with surgery

97605 WILL bundle with the primary surgery when done at the time of that surgery ... in effect, it's considered the "closure." You CAN code it for continued VAC treatment performed on subsequent day(s).

HOWEVER ... let's say that you are performing an appendectomy, and ALSO addressing a large open wound of the chest. Two completely different operative sites. You would need to use a -59 modifier on 97605. You'd probably still get a denial but you would then appeal with operative note(s) showing two distinct operative "incisions."

Hope that helps.

F Tessa Bartels, CPC, CEMC