11042 and 97605

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13
Location
Waterloo, IA
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0
We are getting denials for wound vac with debridement codes as "inclusive". Everything I find says 97605 has been unbundled. Hoping someone can point me in the right direction for more information on this. Thanks.
 

TThivierge

Guru
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144
Location
Lithonia, GA
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CPT 11042 and 97605 not paying

Hi Andrea,

Ah nope that will not work CPT codes 11042 and 97605. Read page 690 in the CPT manual 2018 on left bottom page .... the CPT code 97065 not mentioned but insurance company must think it is not payable. If a different area will cover, cannot be billed for same wound. Send the notes to the insurance company .But it says wound advice in CPT 97605 probably reason not covering it.

I hope this info helps you

Lady T
 
Messages
13
Location
Waterloo, IA
Best answers
0
CPT 11042 and 97605 not paying

Hi Andrea,

Ah nope that will not work CPT codes 11042 and 97605. Read page 690 in the CPT manual 2018 on left bottom page .... the CPT code 97065 not mentioned but insurance company must think it is not payable. If a different area will cover, cannot be billed for same wound. Send the notes to the insurance company .But it says wound advice in CPT 97605 probably reason not covering it.

I hope this info helps you

Lady T
Thank you Lady T!
 
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