tci Part B Insider - 2006 Issue 11

GENERAL SURGERY: You Can't Use A Modifier To Override Wound Care Edits

Anesthesia not separately payable with wound therapy, CMS saysIf you're using cutting-edge wound care techniques in the office, then you may be too advanced to receive any Medicare payment. Bad news: Active wound management codes 97602-97606 will become components of 556 different codes on April 1, including many codes from the integumentary system surgery section. They also become components of a large number of lesion destruction, replantation, fracture care, amputation and neuroplasty codes. You can use a modifier to override almost all of those edits.Meanwhile, 97602-97606 also become mutually exclusive with debridement codes 11000, 11010-11012 and CPT 11720...

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