Wound Care

[rldumond]

If a provider is managing multiple wounds weekly and performs a debridement on one. First visit, you can bill E/M with -25 modifier and the debridement code. However, if this is being done weekly. Do you just bill the next week f/u with debridement code or can you bill for the E/M with -25 modifier b/c of the other wounds.

 

[ole16]

If the provider is seeing the patient weekly and performing a debridement on one wound but also evaluating and managing other wounds (without debridement), then yes... you can bill an E/M with modifier -25 in addition to the debridement code, as long as the documentation supports a separately identifiable E/M service.

To bill both:​

• The E/M note must clearly reflect work above and beyond the pre- and post-operative work of the debridement.
• There should be assessment, decision-making, and possibly changes in management for the other wounds.
• Use modifier -25 on the E/M code to show it's distinct from the procedure.

Don’t bill the E/M if:​

• The note only covers the wound being debrided (procedural care).
• There’s no separate evaluation or management of additional concerns/wounds.

So if the provider is actively managing multiple wounds (not just the one being debrided) and documenting that care, you can definitely report both codes each week. Just make sure it’s well-supported in the note.