Wound Vac placed at surgery

mtreat

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We have one surgeon who places a wound vac at the time of surgery and bills 97607/97608. I have not billed it, stating it is a dressing. I cannot find authoritative reference. Please comment.
 
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Wound vac is considered above and beyond normal wound dressings. It is billable to insurance as long as the provider documents it was placed. The total surface area of the wound must be documented to support billing either 97607 or 97608. If the provider's documentation doesn't indicate the total surface area, he can only bill the 97607.
 

LLovett

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I agree with not billing 97607/97608 in this scenario

It is inappropriate to report these codes when the provider places a vac during surgery. First and foremost the provider is not actually rendering the service defined in the code. See below, I added the bold.

97607
Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters


Not sure who your carrier is but below are documents from 2 different MACs. I copy/pasted some of the more pertinent verbiage. The first one states if you aren't doing what the code describes, don't report it. The second one, I pulled forward the definition of NPWT per WPS Medicare, which is not inclusive of just putting on a vac during surgery.

https://www.cms.gov/medicare-covera...le&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&

Dressings applied to the WOUND are part of the services for CPT codes 97597, 97598 and 97602 and they may not be billed/reimbursed separately. Codes 97602, 97605, 97606, 97607 and 97608 include the application of and the removal of any protective or bulk dressings. However, if a dressing change is performed without any active WOUND procedure as described by these codes, these codes should not be reported.


https://www.cms.gov/medicare-covera...le&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&

Negative Pressure Wound Therapy:
Negative Pressure Wound Therapy (NPWT) involves the application of controlled or intermittent negative pressure to a properly dressed wound cavity. Suction (negative pressure) is applied under airtight wound dressings to promote the healing of open wounds resistant to prior treatments.

I hope this is helpful,

Laura, CPC, CPCO, CPMA, CPC-I, CANPC, CEMC
 
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Niceville, FL
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Wound vac placed at time of initial procedure

I agree with Laura, wound vac placed during initial surgical procedure is considered inclusive to the procedure.
 
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Greenville, TX
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I agree with not billing 97607/97608 in this scenario

It is inappropriate to report these codes when the provider places a vac during surgery. First and foremost the provider is not actually rendering the service defined in the code. See below, I added the bold.

97607
Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters


Not sure who your carrier is but below are documents from 2 different MACs. I copy/pasted some of the more pertinent verbiage. The first one states if you aren't doing what the code describes, don't report it. The second one, I pulled forward the definition of NPWT per WPS Medicare, which is not inclusive of just putting on a vac during surgery.

https://www.cms.gov/medicare-coverage-database/details/article-details.aspx?articleId=53001&ver=10&CoverageSelection=Both&ArticleType=All&PolicyType=Final&s=All&KeyWord=wound+care&KeyWordLookUp=Title&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&

Dressings applied to the WOUND are part of the services for CPT codes 97597, 97598 and 97602 and they may not be billed/reimbursed separately. Codes 97602, 97605, 97606, 97607 and 97608 include the application of and the removal of any protective or bulk dressings. However, if a dressing change is performed without any active WOUND procedure as described by these codes, these codes should not be reported.


https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34587&ver=22&CoverageSelection=Both&ArticleType=All&PolicyType=Final&s=All&KeyWord=wound+care&KeyWordLookUp=Title&KeyWordSearchType=And&bc=gAAAACAAAAAAAA==&

Negative Pressure Wound Therapy:
Negative Pressure Wound Therapy (NPWT) involves the application of controlled or intermittent negative pressure to a properly dressed wound cavity. Suction (negative pressure) is applied under airtight wound dressings to promote the healing of open wounds resistant to prior treatments.

I hope this is helpful,

Laura, CPC, CPCO, CPMA, CPC-I, CANPC, CEMC
Hello I am new to coding and have a wound vac placement question and you seem to really understand it. I work for a podiatry office who does surgery at our local hospitals. I have a case where he used the following CPT 29192 , 10121, 20240 and 29192. He also did a wound vac placement. Can I charge 97605 if the documentation provides the surface area?
 

nick0413

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Could I revive this discussion and add a twist to it? Can a APRN apply the wound vac in a Skilled Nursing Facility and bill for that initial application with 97607/97608?
 
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