Editor’s Note: Cutting through the red tape to make certain that you get paid for every dollar you earn has become more difficult than ever, particularly in our current climate of health care reform and ICD-10 transition. The ACEP Coding and Nomenclature Committee has partnered with ACEP Now to provide you with practical, impactful tips to help you navigate through this coding and reimbursement maze.
Question: How do I code for a wound debridement?
Answer: Current Procedural Terminology (CPT) provides several different coding options for reporting wound debridement service, depending on the type of debridement performed. The most common codes used in the emergency department are 97597 (0.68 relative value units [RVU], $24 for Medicare) for debridement involving the epidermis and/or dermis and 11042 (1.78 RVU, $64 for Medicare) for debridement of subcutaneous tissue. The deepest layer of tissue debrided determines which code to use. Each of these codes is for 20 cm2 or less, and there are additional codes to use when more than 20 cm2 are debrided, 97598 and 11045, respectively. Ideal documentation for debridement should include the depth of tissue (layers) debrided as well as the total surface area of the wound. There are also debridement codes for muscle or fascia (11043) and bone (11044) when performed by the emergency department provider.
Brought to you by the ACEP Coding and Nomenclature Committee.
Dr. Lempert is chief medical officer, coding policy, at TeamHealth, based in Knoxville, Tennessee.