Medical Billing Coding - Wound Care CPT (97597 vs 97602), cpt, codes
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Thread Topic: Wound Care CPT (97597 vs 97602)
Topic Originator: Charissa
Post Date March 22, 2011 @ 6:25 PM
Wound Care CPT (97597 vs 97602)

March 22, 2011 @ 6:25 PM Reply  |  Email Friend   |  |Print  |  Top

I'm trying to get information about wound care coding.  I've been looking online and talking to my hospital's billing department.

I had an infected cyst removed from my left axilla.  A wet-to-dry dressing was used.  I had wound care at the hospital's ICU (weekend) and doctor's office or outpatient pavilion (during the week).  

When I got the hospital's bill ($342 per day for ambulatory procedure and $16 per day for supplies), I questioned what appears to me to be a high charge for a wet-to-dry dressing change. I was told the CPT code used was 97597 with NRV (national revenue) code of 0490 (Ambulatory Procedure).  Is that correct?

The wound size is in compliance with the description of CPT code 97597, but I don't see any other part that applies (waterjet, sharp selective debridement, whirlpool).  Based on my online research, I think I learned that a wet-to-dry dressing is a form of mechanical debridement, which would make it non-selective debridement.  It seems that CPT code 97602 might be more appropriate.

When I called the hospital's billing office to ask about the 97602 code, she said she wasn't sure what NRV code it would be used with as the 0490 doesn't appear to be an option.  She sent me a list of revenue codes and there are some that I can easily tell do not apply (like operating room services, occupational therapy, and speech therapy!) but there are others like clinic general (0510) or freestanding clinic general (0520), etc. that I am not sure if they would apply.  She said if I can find a revenue code that would fit with the CPT 97602 she would be happy to take it to her supervisor for review.

Can someone lend any insight for me? I am only responsible for the deductible and then a coinsurance amount, which will only be a fraction of the $342/day but the total bill will end up being for 7 days so if there is a cheaper code then that would be nice to use.

Thank you.

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