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modifiers with wound care

  1. Red face modifiers with wound care
    Exam Training Packages
    I am VERY new to wound clinic coding and seem to have an issue with what I thought was an appropriate use of modifier 58.

    We have a patient that the Dr performed debriement of wound 9active wound management) along with negative pressure wound therapy.

    I coded this chart as 97597 & 97605 with modifier 58 but now medicare is denying as a bundled service.

    Can someone explain this to me? I am usnure as to why they are saying it is bundled when PN stated clearing that he did both and NCCI edits says a modifier can be applied??

  2. #2
    Fayetteville, NC
    58 is not a valid modifier for 97605 per Payer Path (and neither is -51) that may be why they are still denying it.
    59 is a valid modifier but you can only use it if the wound vac is a separate and distinct service from the removal of devitalized tissue. It seems to me as if the wound vac may be included in the 97597......
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

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