Wiki Can an RN perform/bill CPT 97597?

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cfraker

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Good morning all!

I just started working at a FQHC and am still learning when/if a nurse can bill for services. I used to do E&M coding for a general surgeon and a neurosurgeon but they didn't have any nurses perform/bill any services. I know they can bill CPT 99211 (obvi) but can anyone tell me if RN's can perform/bill for a Debridement (CPT 97597)?

Thank you,
Cristy
 
Hi Cristy,
An RN cannot bill for nor perform the services defined by 97597. This service is limited to a physician, NPP, PA, and CNS or physical therapist. Some physicians will argue that an RN can provide the treatment if under their supervision, however, this is not appropriate. I have attached the CMS guidelines.

 
Hi Cfraker
cfraker said:
Good morning all!

I just started working at a FQHC and am still learning when/if a nurse can bill for services. I used to do E&M coding for a general surgeon and a neurosurgeon but they didn't have any nurses perform/bill any services. I know they can bill CPT 99211 (obvi) but can anyone tell me if RN's can perform/bill for a Debridement (CPT 97597)?

Thank you,
Cristy
Click to expand...
If the RN is certified in this she or he can do the debridement in pressure ulcers cpt 97597 in certain setting such as nursing home or LTC rehab facilities. FHQC setting probably not have nurses do this treatment. However a MD, DO or PA must give the order. When pressure ulcer detection, prevention, and treatment are discussed in the acute care setting, these tasks are often delegated to registered nurses (RNs) and certified wound and ostomy care nurses (CWOCNs) and depend on routine patient assessments. Reference https://rehabpub.com/mobility/pressure-ulcer-prevention/. The info above stated RN can do it if in their scope of work and certified in this area plus ordered by MD. Reference : https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53296
Lady T
 
TThivierge said:
Hi Cfraker

If the RN is certified in this she or he can do the debridement in pressure ulcers cpt 97597 in certain setting such as nursing home or LTC rehab facilities. FHQC setting probably not have nurses do this treatment. However a MD, DO or PA must give the order. When pressure ulcer detection, prevention, and treatment are discussed in the acute care setting, these tasks are often delegated to registered nurses (RNs) and certified wound and ostomy care nurses (CWOCNs) and depend on routine patient assessments. Reference https://rehabpub.com/mobility/pressure-ulcer-prevention/. The info above stated RN can do it if in their scope of work and certified in this area plus ordered by MD. Reference : https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53296
Lady T
Click to expand...
While the CMS coverage database article is poorly written, or clear as mud as I like to put it, it states:
"For hospital patients and for SNF patients who are in a Medicare covered
stay, there is no Medicare Part B coverage of the services of physician-employed
auxiliary personnel as services incident to physicians’ services under §1861(s)(2)(A) of
the Act. Such services can be covered only under the hospital or SNF benefit and
payment for such services can be made to only the hospital or SNF by a A/B MAC (A).
(See §80 concerning physician supervision of technicians performing diagnostic x-ray
procedures in a physician’s office.)"
This likely does not apply to an FQHC.
 
Hello Podcaster
Yup that is info written above .........I quoted FQHC setting probably not able to do this debridement by RN. ;)
Lady T
 
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