Wiki CPT codes 97605 and 97607

[tawneymurphy]

Good morning,

I am new to coding Incision and drainage coding, I am a cardiovascular coder. I need help understanding CPT codes 97605 and 97607 and what it means when it states durable medical equipment and disposable non durable medical equipment. As i am reading reports i am noticing that most all of the time a wound vac system is used, my question is would a wound vac system be consider DME or disposable DME?

What documentation would the physician need to document in order for this t be a billable service? As of right now the 5 reports that i have looked at have wound vac sponges were placed followed by the wound vac dressings or wound vac dressings were placed or with wound vac. Is this enough?

Thank you, anything helps

 

[thomas7331]

A wound vac can be either DME or disposable - there are both types. The DME vac is reusable and would usually be provided to the patient on a rental basis by a DME company and returned when no longer needed. The disposable kind is a battery-operated suction device and is discarded after use. Typically the type or brand name of the device and/or the invoice should be documented in the record somewhere and you may be able to review that manufacturer's web site for additional information and/or coding and billing instructions. There aren't any specific documentation guidelines that I'm aware of, but the note should document the treatment and dressing of the wound as well as the application of the device.

I'd note though, that the placement of these devices on a post-operative wound is normally inclusive and global to the I&D procedures and many other surgeries, so you would not bill these codes for the surgeon professional charge in addition to the procedure on the same date or during the post-operative period. Also, many payers have medical necessity policy guidelines for the use of these devices - these are typically used for patients that have problems with chronic or non-healing wounds, and many payers won't consider them necessary for routine use after surgeries on otherwise healthy patients.

Hope this helps some.