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Active wound care 97597-97598 vs 11042-11045

Chris Posted Thu 12th of September, 2019 15:12:40 PM
Our doctor is doing wound care on a venous ulcer of the leg. The wound is 26 sq sm and fat layer is exposed. We need clarification on the use of active wound care and debridement coding. CPT says 97597 is for epidermis and/or dermis only. The doctors chart indicates he used a sharp debridement down to and including the subcutaneous tissue layer. Fibrin deposits and devitalized tissue were removed. Hemostasis was achieved by pressure. Which set of codes apply. Active wound care or debridement? Thank you
SuperCoder Answered Fri 13th of September, 2019 04:52:56 AM

Hi,

Thanks for your question.

Subcutaneous tissue is found just below the skin, or dermis, layers; there are three layers of skin known as epidermis, dermis, and hypodermis; subcutaneous tissue is the lowermost layer called hypodermis.

Active wound care procedures are performed to remove devitalized and/or necrotic tissue and promote healing.

Depth of wound is the only documentation item that determine the correct code.

The doctors chart indicates that he used a sharp debridement down to and including the subcutaneous tissue layer.

Since, the wound care management codes 97597 and 95598 are for debridement of the upper layer(s) of skin (dermis and epidermis) only.

Therefore, code range 11042-11045 will be more appropriate to use.

Hope this helps.

Thanks.

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