Medicare Compliance & Reimbursement - 2011 Issue 9
NCCI Update: 97597-97598: Correct This Selective Debridement CCI Glitch in Your Notes
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Article Overview
This premium article discusses a coding edit problem involving wound care debridement services and the correction process announced by the relevant organizations. It is aimed at coders, billing staff, and practices that submit claims for active wound care management, with emphasis on understanding the scope of the issue, the organizations involved, and the need to monitor payer guidance while the edit is being updated.
Why This Topic Matters
It helps readers identify a temporary claims-edit problem that may affect reimbursement and denial patterns for wound care debridement services, and shows why practices need to watch for payer and association updates before submitting or resubmitting affected claims.
Article Sections
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NCCI update and claim-impact overview
Introduces the claims-edit issue affecting wound care management coding and explains why it is drawing attention from coders and practices.
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APMA statement and edit correction status
Summarizes the professional association response, the organizations involved, and the status of the correction process for the edit.
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Claims processing and payer follow-up
Notes the temporary billing implications and the need to monitor Medicare contractor communications for additional guidance.
What You Will Learn
- The general nature of the coding issue affecting wound care debridement claims
- Which organizations are involved in identifying and correcting the edit problem
- What types of follow-up guidance practices may need to monitor from payers and contractors
- Why temporary claim delays or denials may occur while an edit correction is being implemented
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Podiatry practices
- Wound care providers
- Revenue cycle teams
Codes Discussed
Modifiers Discussed
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