Neg. Pressure Wound Tx 97605

jdibble

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Looking for an answer too!

Can any one answer this question? I was wondering the same thing as my Plastic Surgeon insists that it can be billed because her sales rep told her so! If someone can please answer this and provide any documentation to support yes or no I would be forever greatful!!!

Thanks, :)
 

ASH527

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Williamsburg, MA
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Wound care codes

I am trying to find the correct code for wound vac placement - I am leaning towards the code 97605 as the description seems suitable - but I was wondering if there was a HCPCS code as well - it would be great if anyone could shed some insight in this matter.
 

mjewett

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97605 is the correct code for wound VAC. We have not been successful in billing for the first placement of the VAC in the O.R. also another thing to keep in mind is if your patient is discharged, and will be receiving home health care. Insurance carriers will only cover the home health agency changing the VACs. Often times, during a post-op visit the surgeon or Phys. Assistant in our office will change the VAC, but we can't get reimbursed if the pt is also receiving that service from Health Health Agency.
 

Grintwig

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We have placed a very few in the office and a few in the hospital and been paid for most of them.
Our problem is when they pay for the wound vac they do not want to pay for any of the follow up wound care (including wound treatment weeks later) but there is no global on the wound vac.
 

herrera4

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so could you bill 97605-58 in the office during a post-op? When post op visit is booked know if the vac will have to be changed
 

jdibble

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Global rules shouldn't apply, you wouldn't need the 58.
Why wouldn't global rules apply? If the VAC is applied during a surgical procedure and that procedure has a global, wouldn't the VAC fall under the global for the operative procedure? For instance, my doctor wants to bill the 97605 with 15100 which has a global of 90 days. Any procedure done during that time would be under that global, so why wouldn't the VAC fall under that?

I am still on the fence about whether we can bill the 97605 in the OR - does anyone have solid documentation on this - and I don't mean anything from a sales rep or VAC company! :)

Thanks,
 
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I have been told that you can't code for placement of wound vac just like you can't code for skin closure. It's just a different type of dressing? Any thoughts?

I don't think 58 or 78 modifier applies to procedures in the office. They require a return to the operating room. And CMS won't pay for procedures done in the office during the global period.

So is there a modifier for procedures done in the office during the global period?
 
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