Understanding CPT Code 97597: A Comprehensive Guide

In the medical field, accurate and standardized coding is essential for proper documentation, billing, and reimbursement. One such code that plays a crucial role in wound care management is CPT code 97597. CPT code 97597, titled “Debridement (e.g., high-pressure water jet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (e.g., 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 square cm or less,” is used to report the debridement of open wounds.

This code specifically applies to debridement procedures performed on wounds that measure 20 square centimeters or less. In this blog post, we will delve into the details of CPT code 97597, discussing its definition, usage, documentation requirements, and associated considerations.

Proper Coding for CPT code 97597

When coding for wound debridement using CPT code 97597, there are a few important considerations to keep in mind:

  • Time-based coding: CPT code 97597 is a time-based code that represents a single session of wound debridement. It does not account for the specific duration of the procedure. Providers should document the service time in the patient’s record.
  • Wound size limitation: Remember that CPT code 97597 applies to wounds with a surface area of 20 square centimeters or less. If the wound exceeds this size, a different code, such as 97598 for each additional 20 square centimeters, should be used.
  • Documentation accuracy: Accurate and detailed documentation is crucial for coding and billing purposes. Ensure that the documentation supports the medical necessity of the debridement procedure and justifies the use of CPT code 97597.
  • Medical necessity: Debridement should be performed based on medical necessity. The documentation should include the rationale for debridement, such as the presence of necrosis, nonviable tissue, or signs of infection in the wound, as well as the expected benefits of debridement in promoting wound healing.
  • The uniqueness of procedures: While CPT code 97597 covers various debridement techniques, it is essential to accurately describe the specific methods and tools used during the procedure. This information helps provide a clear picture of the services rendered and supports proper coding.

Usage and Documentation Requirements

CPT code 97597 is typically used for wounds that require active debridement. Debridement is the process of removing nonviable tissue, foreign material, or contaminants from a wound to facilitate proper healing. The code encompasses various methods of debridement, including high-pressure waterjet, sharp selective debridement with scissors, scalpel, and forceps. To accurately report CPT code 97597, healthcare providers must document the following information:

  • Wound assessment: The documentation should include a thorough assessment of the wound, noting its size, location, stage, and any associated complications or comorbidities.
  • Debridement technique: Specify the debridement method used, such as a high-pressure water jet, sharp selective debridement, or a combination of techniques. Additionally, document the extent of debridement, including the types of tissue removed (fibrin, devitalized epidermis/dermis, debris, biofilm, etc.).
  • Topical application: If any topical agents or dressings are applied after debridement, detail the specific products used.
  • Wound surface area: Measure and document the wound’s surface area, ensuring it is 20 square centimeters or less to align with the code’s criteria.
  • Whirlpool use and ongoing care instructions: If a whirlpool is used during the session or if instructions for ongoing care are provided, include this information in the documentation.

CPT code 97597 is a valuable tool for reporting and documenting wound debridement procedures. By understanding the code’s definition, documentation requirements, and associated considerations, healthcare providers can ensure accurate coding and appropriate reimbursement for their services. Proper documentation, including a comprehensive wound assessment, description of debridement techniques, measurement of wound surface area, and indications of medical necessity, is essential for using CPT code 97597 effectively.

Note that CPT® is a registered trademark of the American Medical Association. The information provided in this article is for provider educational purposes only and should not be construed as medical advice. Healthcare providers should consult the latest coding guidelines and if required, should seek guidance from coding experts for accurate coding practices.

About Medical Billers and Coders (MBC)

Medical Billers and Coders (MBC) is a leading wound care billing company known for its expertise and proficiency in handling the complex billing and coding requirements of wound care services. With a team of highly skilled and certified medical billers and coders, MBC ensures accurate and timely submission of claims, maximizing reimbursement for healthcare providers specializing in wound care.

By partnering with MBC, healthcare providers can focus on delivering exceptional wound care services while entrusting their billing and coding processes to a trusted industry leader. To know more about our wound care billing services, email us at: info@medicalbillersandcoders.com or call us at: 888-357-3226.