ED Coding and Reimbursement Alert

Question: A patient came to the ED for treatment of a pressure ulcer on her lower back. The physician removed devitalized tissue from the ulcer using a waterjet and forceps. The surface area of the wound was 13 square centimeters. Can we report a code for the waterjet use in addition to the debridement code?

Montana Subscriber

Answer: No, you cannot report the waterjet separately, because the active wound care codes bundle waterjet use into the service. On the claim, you should report 97597 (Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less) for the debridement.

Use the appropriate ICD-10-CM code to describe the pressure ulcer, such as L89.139 (Pressure ulcer of right lower back, unspecified stage).