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Billing 97597 with Medicare

  1. Default Billing 97597 with Medicare
    Medical Coding Books
    How do you bill this code with Medicare?


  2. #2
    Madison, Wisconsin
    97597 is billed for the first 20sq cm or less. Do not use a location modifier as it is per session/total wound area. I find Medicare pays it at $55.47. Keep in mind that if the patient is in a skilled nursing facilty under Medicare even though the patient is seen in office you will need to bill the facility not Medicare. If other services such as nail debridment was performed during the same session you can also bill for those services as well. The APMA coding resource web page is very helpful in which code would be billed as line one vs line two items. Hope this information is helpful to you.

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