Clinical Audit recently completed a review of CPT code 97597 (Active Wound Care Management, selective debridement). Conservative sharp debridement is the classical method of selective wound debridement and is a minor procedure that typically requires no anesthesia. Scalpel, scissors and tweezers/forceps may be used to remove only clearly identified devitalized tissue. Generally, there is no bleeding associated with this procedure.
Submitted records included 82 services and, after review, a denial rate of 59% was found.
Documentation was lacking the specific information needed to support wound debridement as described in LMRP/LCD 102-03. Some records described sharps, dull and mechanical debridement, as well as pulsed lavage as forms of selective debridement.
Claims for wound care services remain to be a high area of reimbursement for providers due to the specific type of care. However, providers are receiving decreased or no reimbursement due to higher wound care denial rates. Accurate coding and documentation is essential and providers need to focus on submitting documentation that meets appropriate guidelines and supports the codes reported to avoid continued denials.
Reference LCD 102-03
Additional Information:
08/27/2008 - Effective September 1, 2008, the state of New Jersey removed from the Primary Geographic Jurisdiction as required by the MAC-PartA/PartB contractor workload number 12401
History:
08/27/2008 - Effective September 1, 2008, the state of New Jersey removed from the Primary Geographic Jurisdiction as required by the MAC-PartA/PartB contractor workload number 12401
08/02/2009 - In accordance with Section 911 of the Medicare Modernization Act of 2003, this policy/article was retired due to transition from FI Riverbendgba (00390) to MAC Part A Cahabagba (10301)
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