Billing and Coding: Wound Care

This billing and coding guidance states that active wound care management codes (97597, 97598, 97605–97608) and surgical debridement codes (11000–11012, 11042–11047) are payable when documentation supports the procedure and the selected CPT reflects the deepest tissue removed. Dressings and certain adjuncts (e.g., whirlpool, Unna boot supplies) are generally included in debridement or wound-care codes and may not be billed separately; CPT 97602 is bundled (not separately payable) for physician services, and specific inpatient-only and NCCI edit restrictions apply. Claims must include a specific ICD-10-CM diagnosis linked to the procedure, therapists must append appropriate therapy modifiers and revenue codes, E/M services on the same day must be separately identifiable in the record, and CPT 97610 is limited to one service per day per qualifying wound.

"Active wound care management CPT codes 97597, 97598, 97605, 97606, 97607, and 97608 are billable when active wound care management services are performed."