Wiki Debridement

[tmorehart]

I am looking for opinions on this scenario.

A patient has been to visit our wound clinic 3 times for burns, each time the wounds have been debrided and I coded this with a 16020, however now the physician is saying that the wounds have converted to chronic non-healing ulcers and he wants me to use the 97597 skin debridement code. I feel that this should still be a burn debridement as the wounds have never healed.

I would greatly appreciate some other opinions

Thank you,

Tracey

 

[MarcusM]

This CPT code 16020 is for the dressing and/or debridement of a partial–thickness burn (either initially or subsequently). In this instance the burn is small (less than 5% of the total body surface area).

Clinical Responsibility
For treatment of a burn wound, a physician first cleans the wound with an antiseptic solution. Then the physician removes blisters, loose or dead skin, and tissues in order to inhibit the growth of microbes and to aid the healing process. The wound is then dressed with sterile gauze and ointments to promote sterile healing. Use this code if the burn area is less than 5% of total body surface area.

Terminology
Partial thickness burns almost always refer to second degree burns (involving both the epidermis and dermis, either superficial or deep).

Tips

Additional Info
You should also code any subsequent burn treatment. For instance, if the physician has the child return for debridement or a dressing change without anesthesia, you may report CPT code 16020 again. CPT code 16020 has zero global days.

CPT 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

This code indicates complete wound care management such as wound assessment (complete discussion and advise on possible treatment), debridement by using high pressure waterjet or sharp selective techniques, topical applications, use of a whirlpool prior to debridement, instructions for ongoing wound care etc. Use this code if physician removes wound surface area of first 20 sq cm or less.