Wiki Wound Care - wound care only

Cindy Whitt

Athens, AL
Best answers
Can you please tell me if there is a specific code for wound care only. My understanding and all the information I find says bill an E&M visit when cleaning and rebandaging a wound. My doctor insists that there is a wound care code to bill. I don't think there is. Can you add some clarification please.

Thank you
Cindy Whitt, CPC
Family Medicine
Yes, I think those are the codes to which he is referring. However, he is not doing any debridement, removal of tissue, or therapy. He is only cleaning and re-bandaging the wound. So, my understanding is you cannot use these, but I think he still believes you can. There was an article in the AAPC Coding Edge, June 2011, which addressed this and from the way I understand what he is doing, according to that article you only bill E&M.
Debbie J

Sorry this is a late reponse. I have not been reading all forum categories lately. I do mostly surgery billing and my surgeons see a lot of patients for "wounds" (mostly ulcers in diabetic patients). They do some treatments in the office:

Debridement-subcutaneous tissue (includes dermis and epidermis) CPT 11042; first 20 sq. cm. or less

Debridement- dermis and epidermis only. CPT 97597 (must use instruments such as scalpel and forceps or scissors) 20 sq. cm. or less.

Removal of devitalized tissue from wound (dermis and epidermis only). CPT 97602 ( no instruments used)

There is more detailed description in the CPT book for these codes, but the bottom line is that your provider need to document "exactly what was done" beyond changing the dressing (part of the E/M service).