Wiki Wound care

[donnalee@forbesmt.com]

If a patient is referred to a wound care specialist for treatment by his PCP, evaluated in the office as a new patient and has a subsequent debridement (CPT 97597) in the office during the appointment, is it appropriate to bill both 99204 & 97597? There is no CCI for these two codes.

 

[csperoni]

As long as the note and medical necessity supports 99204, you can bill them both, perhaps with -25 on the E/M to indicate it was a separate service.
Whenever I have someone questioning whether to bill an E/M with procedure, I tell them to cross out in the note anything that was necessary to perform the procedure or part of the procedure, and then see if what is left stands as an E/M service.

https://www.hcpro.com/HIM-241732-859/QA-May-we-bill-an-EM-code-for-a-wound-care-first-visit.html