ED Coding and Reimbursement Alert

Medicare carrier lays out definitions for each type of debridement Does deciding between surgical debridement and active wound care management (AWCM) codes give you fits? The choice is not always easy because the difference between the two procedures is very slim. But you owe it to the practice to know when to report a surgical debridement (11000-11044) and when you should opt for AWCM (97597-97598). Otherwise, your coding could be inaccurate. Check out this explanation from Pinnacle Medicare Services, a carrier in Missouri, and keep it handy when deciding on the proper debridement code: "Please note differences between surgical debridement codes and active wound care management codes: - "Surgical debridement procedures can be complex surgical procedures and often require the use of general anesthesia. These codes are often performed under sterile conditions, with the removal of all eschar/devitalized tissue to a vital wound bed, by surgeons or professionals highly trained in the procedure. Active wound care management is performed under clean conditions with the use of sterile instruments and sterile/clean dressings. - "Billing of surgical debridement codes is for individual sites and not per session. Active wound care management codes are billed per session and not per individual wounds. - "Surgical debridement is typically reported for the initial service to clear the site and to establish the margins of viable tissue. These codes must be based on debridement of actual tissue level and not the depth/grade of the ulcer or wound. - "Active wound care management procedure includes wound assessment and debridement; application of ointments, creams, sealants, and other wound coverings; and instructions for ongoing care."