Wound care question

tfrick2

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We have a patient with a large wound (~100 cm) who comes in for debridement and wound care. This was initially coded as 97595, 97596 x4 units, but comes back on our error report as a medically unlikely service for the 97598 x4. Does anybody know the best way to code for this patient? Would it be better to bill each 97598 on a separate line?

Thank you in advance!
 
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Appeal with copy of report

What they are saying when they say it is "medically unlikely" is that they want to see some proof of the size of the wound. Appeal with a copy of the report.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 

tfrick2

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The error is on our interal edit report; this hasn't even billed to the insurance co yet (which happens to be Medicare).

Tracy
 
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