I just went around and around on this very subject on two different forums. The opinions really vary. My confusion was the statement in CPT..."Provider is required to have direct (one-on-one) patient contact." I took that to mean that 97597-97606 required provider contact. Then...I discovered the CPT Assistant article from 2005 stating active wound care mgmt codes were reserved for NPP's. I have to be honest, that confused me. So...I sent out my question and received yes and no answers. My provider did provide the article from KCI (manufacturer) indicating that these were appropriate for providers. I also received the article from the AAOS...
Q: We just learned that we can report the application of a wound vacuum dressing. What codes do we use?
A: Negative-pressure wound therapy is reportable when the documentation supports the service. In 2007, the AAOS updated the Global Service Data for Orthopaedic Surgery book to classify this as an “excluded service” for all musculoskeletal and integumentary codes. The following verbiage is in the “Intraoperative services not included in the global surgical package” section of Global Service Data:“2. complicated wound closure ( eg, application of wound vacuum device to open wound) or closure requiring local or distant flap coverage and/or wound vacuum device to open wound) or closure requiring local or distant flap coverage and/or skin graft, when appropriate (eg, 13160, 14000-14350, 15000-15400, 15570-15776)”
CPT codes 97605 (Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters) and 97606 (Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters) describe the services; it may be necessary to append modifier 59 to indicate a distinct procedure if other services are reported at the same session.
So then...I check with my Medicare carrier and they do allow this service with particular ICD-9 codes. They do not state the provider can't provide this service but it doesn't necessarily state they can. So between CPT, the AAOS article, the KCI article and Medicare not really suggesting one way or the other...our providers bill for these...until further notice....