We have already learnt a lot in surgery coding. We are now updated with the new spinal epidural injection codes of 2017. To become a perfect in coding, coders really need to remain updated with each and every CPT code. Medical coders need to be more perfect in coding diagnostic and interventional radiology cpt codes. Every year their have been lot of new codes added in the procedure coding. Hence, coders need to be more focused while coding new codes. Earlier we have learnt about selective and non-selective catheterization of veins. We have going to learn more about selective and non-selective techniques in coding debridement procedure.
There are two types of debridement, selective and non-selective. In Selective debridement techniques, the provider has complete control over the tissue which is being removed. These techniques include the use of high pressure waterjet with or without suction. Also, the use of scissors, a scalpel or forceps is required for selective debridement. We have separate CPT codes for these types of debridement. CPT code 97597 and 97598 are used for coding selective debridement. These codes are used when the debridement is done on epidermis and/or dermis level of skin only. While the non-selective debridement which involves removal of devitalized tissue from the wound. These debridement techniques are done without anesthesia and do not involve the use of sharp objects. If you can see the code description, it will include the topical application, dressing, larval therapy as well. CPT code 97602 is used for coding these non-selective debridement procedures. These procedures may require more than one visit.
CPT code description for 97597, 97598 and 97602
97597: Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less
97598; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
(Use 97598 in conjunction with 97597);
97602: Removal of devitalized tissue from wound(s), nonselective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session
Non-selective debridement is used to promote healing using non-selective debridement techniques. These are also sometimes referred as mechanical debridement. This technique includes wet to moist dressing, enzymatic chemicals, abrasion and larval therapy. There is not surface area specified for coding 97602 CPT code.
Use CPT code 11043-11046 for coding debridement of muscle. Only when the epidermis and dermis portion of the skin is debrided, use active wound care management CPT Code 97597 & 97598.