Medicare Compliance & Reimbursement

Active wound therapy requires different documentation than debridement. Question: When the surgeon performs a wound VAC or cleans a wound by scraping with a sharp curette (not excising tissue), is it appropriate to use a debridement code or should we report an active wound care management code from the range 97597"97606? Answer: Physicians typically use the debridement codes (11000"11001, Debridement of extensive eczematous or infected skin; ... or 11004"11005, Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; ...) for debridement by any method. Without question these codes most closely describe wound debridement by sharp curettement. You should only report wound care management codes such as 97605"97606 (Negative pressure wound therapy [e.g., vacuum assisted drainage collection], including topical application[s], wound assessment, and instruction[s] for ongoing care, per session; ...) for a therapeutic service that involves more than simple wound debridement. These codes require "direct (one-on-one) patient [...]