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Wiki Wound Vac placed at surgery
- Thread starter mtreat
- Start date
Danipitman1027
New
Wound vac is considered above and beyond normal wound dressings. It is billable to insurance as long as the provider documents it was placed. The total surface area of the wound must be documented to support billing either 97607 or 97608. If the provider's documentation doesn't indicate the total surface area, he can only bill the 97607.
I agree with not billing 97607/97608 in this scenario
It is inappropriate to report these codes when the provider places a vac during surgery. First and foremost the provider is not actually rendering the service defined in the code. See below, I added the bold.
97607
Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
Not sure who your carrier is but below are documents from 2 different MACs. I copy/pasted some of the more pertinent verbiage. The first one states if you aren't doing what the code describes, don't report it. The second one, I pulled forward the definition of NPWT per WPS Medicare, which is not inclusive of just putting on a vac during surgery.
https://www.cms.gov/medicare-covera...le&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&
Dressings applied to the WOUND are part of the services for CPT codes 97597, 97598 and 97602 and they may not be billed/reimbursed separately. Codes 97602, 97605, 97606, 97607 and 97608 include the application of and the removal of any protective or bulk dressings. However, if a dressing change is performed without any active WOUND procedure as described by these codes, these codes should not be reported.
https://www.cms.gov/medicare-covera...le&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&
Negative Pressure Wound Therapy:
Negative Pressure Wound Therapy (NPWT) involves the application of controlled or intermittent negative pressure to a properly dressed wound cavity. Suction (negative pressure) is applied under airtight wound dressings to promote the healing of open wounds resistant to prior treatments.
I hope this is helpful,
Laura, CPC, CPCO, CPMA, CPC-I, CANPC, CEMC
It is inappropriate to report these codes when the provider places a vac during surgery. First and foremost the provider is not actually rendering the service defined in the code. See below, I added the bold.
97607
Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
Not sure who your carrier is but below are documents from 2 different MACs. I copy/pasted some of the more pertinent verbiage. The first one states if you aren't doing what the code describes, don't report it. The second one, I pulled forward the definition of NPWT per WPS Medicare, which is not inclusive of just putting on a vac during surgery.
https://www.cms.gov/medicare-covera...le&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&
Dressings applied to the WOUND are part of the services for CPT codes 97597, 97598 and 97602 and they may not be billed/reimbursed separately. Codes 97602, 97605, 97606, 97607 and 97608 include the application of and the removal of any protective or bulk dressings. However, if a dressing change is performed without any active WOUND procedure as described by these codes, these codes should not be reported.
https://www.cms.gov/medicare-covera...le&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&
Negative Pressure Wound Therapy:
Negative Pressure Wound Therapy (NPWT) involves the application of controlled or intermittent negative pressure to a properly dressed wound cavity. Suction (negative pressure) is applied under airtight wound dressings to promote the healing of open wounds resistant to prior treatments.
I hope this is helpful,
Laura, CPC, CPCO, CPMA, CPC-I, CANPC, CEMC
angelaallen_cpc
New
Wound vac placed at time of initial procedure
I agree with Laura, wound vac placed during initial surgical procedure is considered inclusive to the procedure.
I agree with Laura, wound vac placed during initial surgical procedure is considered inclusive to the procedure.
Hello I am new to coding and have a wound vac placement question and you seem to really understand it. I work for a podiatry office who does surgery at our local hospitals. I have a case where he used the following CPT 29192 , 10121, 20240 and 29192. He also did a wound vac placement. Can I charge 97605 if the documentation provides the surface area?
Could I revive this discussion and add a twist to it? Can a APRN apply the wound vac in a Skilled Nursing Facility and bill for that initial application with 97607/97608?
Based on CPT Assistant and multiple KZA articles, wound vacs are billable when placed at the time of surgery (as long as they are documented correctly).
_________________________________________________________________________________________________________________________________________________
CPT Assistant, October 2021 Page: 13 Category: Frequently Asked Questions
Question: Does negative-pressure wound therapy (97605-97608) apply to both open and closed wounds?
Answer: Yes, negative-pressure wound therapy may be performed on open or closed wounds.
_________________________________________________________________________________________________________________________________________________
Question:
I’m a general surgeon. Some of my team are reporting the negative pressure wound therapy codes 97605 and 97606 when applying wound vacs after closing at the completion of their surgical cases. As a result, I am told by my coders that billing for these wound vacs is not appropriate, since there is a Medicare NCCI edit that bundles this with more comprehensive procedures at the same anatomic area.
The physicians and coders disagree about how to handle these edits. Some of the physicians believe the wound vacs are billable because they are applied to the skin which constitutes a different body system. The coders think the wound vacs are dressings which are included in the global surgical fee and would not billable. After multiple discussions with the physicians and coders, we are unable to provide a definitive answer. Could I please ask you for your advice regarding this issue? What is the right answer?
Answer:
The AMA published clarification on wound vac billing in the October 2021 CPT Assistant. Negative pressure wound therapy (97605-97606) is considered billable for both open and closed wounds. However, that does not mean that payors will reimburse separately for the service, so use caution and track results.
*This response is based on the best information available as of 04/27/22
www.karenzupko.com
www.karenzupko.com
www.karenzupko.com
www.karenzupko.com
_________________________________________________________________________________________________________________________________________________
CPT Assistant, October 2021 Page: 13 Category: Frequently Asked Questions
Question: Does negative-pressure wound therapy (97605-97608) apply to both open and closed wounds?
Answer: Yes, negative-pressure wound therapy may be performed on open or closed wounds.
_________________________________________________________________________________________________________________________________________________
Wound Vac Billing
April 7, 2022
Question:
I’m a general surgeon. Some of my team are reporting the negative pressure wound therapy codes 97605 and 97606 when applying wound vacs after closing at the completion of their surgical cases. As a result, I am told by my coders that billing for these wound vacs is not appropriate, since there is a Medicare NCCI edit that bundles this with more comprehensive procedures at the same anatomic area.
The physicians and coders disagree about how to handle these edits. Some of the physicians believe the wound vacs are billable because they are applied to the skin which constitutes a different body system. The coders think the wound vacs are dressings which are included in the global surgical fee and would not billable. After multiple discussions with the physicians and coders, we are unable to provide a definitive answer. Could I please ask you for your advice regarding this issue? What is the right answer?
Answer:
The AMA published clarification on wound vac billing in the October 2021 CPT Assistant. Negative pressure wound therapy (97605-97606) is considered billable for both open and closed wounds. However, that does not mean that payors will reimburse separately for the service, so use caution and track results.
*This response is based on the best information available as of 04/27/22
Wound Vac Billing - KarenZupko&Associates, Inc.
dictating CPT codes in the operative note so that my coder knows what to bill. Recently, we had an insurance company call us out...What is your advice?
www.karenzupko.com
Wound Vac Billing - KarenZupko&Associates, Inc.
dictating CPT codes in the operative note so that my coder knows what to bill. Recently, we had an insurance company call us out...What is your advice?
www.karenzupko.com
Wound Vac Billing - KarenZupko&Associates, Inc.
Iatrogenic, intraoperative complications that are repaired at the same operative session are not separately reported. Since the small bowel...
www.karenzupko.com
Are Wound Vacs Separately Reportable? - KarenZupko&Associates, Inc.
Question: I oftentimes bill and E/M code with modifier 25 for an office visit and 92504-50 (1 unit) for the binocular microscopy to Medicare...
www.karenzupko.com
Last edited:
Fakhruddin Saifi
New
What would be the coding for PICO.....