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Q:

Wound Debridement: What's the difference between CPT codes 97601 and the CPT series 11040-11044?

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Providers should select the appropriate debridement code according to the type of tissue removed. Medical reviews have found that providers are confusing the depth of the wound versus the type of tissue removed when billing for debridement. An example of this would be the beneficiary having a wound extending to the muscular layer, but the provider debrides only infected subcutaneous tissue. This service would be billed with CPT code 11042. CPT codes 11040 - 11044 clearly describe the type of layer removed. If the debridement service consists of the removal of less defined devitalized (necrotic) tissue that is superficially lining the wound bed, commonly referred to as slough, then the provider should bill 97601. Generally, the performance of services described by CPT codes 11040 - 11044 requires more complex surgical skills, whereas, CPT code 97601 consists of the elimination of superficial debris, for example with a high pressure waterjet, scissors, scalpel, and tweezers. If the ... more
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