How To Use CPT Code 97597

CPT 97597 involves the debridement of open wounds, including various techniques and treatments for a total wound surface area of 20 cm2 or less. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 97597.

1. What is CPT 97597?

CPT 97597 is a medical procedure code used to describe the debridement of open wounds, which involves the removal of devitalized tissue using various techniques. This code is applicable for wounds with a total surface area of 20 cm2 or less and may include additional treatments such as topical applications, wound assessment, whirlpool, and instructions for ongoing care.

2. 97597 CPT code description

The official description of CPT code 97597 is: “Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less.”

3. Procedure

The 97597 procedure involves the following steps:

1. Preparation of the patient, including anesthesia if necessary.
2. Selection of the appropriate debridement technique, such as sharp debridement with scissors, forceps, or a scalpel, or high-pressure waterjet with or without suction.
3. Removal of devitalized tissue, debris, and other unwanted materials from the open wound.
4. Control of bleeding and preservation of viable tissue.
5. Application of topical treatments, if applicable.
6. Wound assessment and documentation.
7. Use of a whirlpool for wound cleansing, if performed.
8. Instruction for ongoing care and follow-up appointments.

4. Qualifying circumstances

Patients eligible to receive CPT code 97597 services are those with open wounds requiring debridement due to the presence of devitalized tissue, debris, or other unwanted materials. The wound’s total surface area must be 20 cm2 or less for this code to be applicable. Patients with more extensive wounds may require additional codes or procedures.

5. When to use CPT code 97597

It is appropriate to bill the 97597 CPT code when a patient has an open wound with a total surface area of 20 cm2 or less that requires debridement. The procedure must involve the removal of devitalized tissue using one of the specified techniques and may include additional treatments such as topical applications, wound assessment, whirlpool, and instructions for ongoing care.

6. Documentation requirements

To support a claim for CPT 97597, the following information must be documented:

• Patient’s medical history and relevant diagnoses.
• Physical examination findings, including wound location, size, and characteristics.
• Selected debridement technique and rationale for its use.
• Details of the debridement procedure, including the amount of tissue removed and any complications encountered.
• Topical treatments applied, if any.
• Wound assessment findings, including any changes in the wound’s appearance or condition.
• Use of a whirlpool, if performed.
• Instructions provided for ongoing care and follow-up appointments.

7. Billing guidelines

When billing for CPT code 97597, it is essential to follow the appropriate guidelines and rules. Ensure that the patient meets the qualifying circumstances for this code, and the procedure is performed as described in the official CPT code description. Additionally, proper documentation must be maintained to support the claim. For wounds with a total surface area larger than 20 cm2, consider using additional codes or procedures as needed.

8. Historical information

CPT 97597 was added to the Current Procedural Terminology system on January 1, 2005. The code’s description was changed on January 1, 2011, to its current form.

9. Similar codes to CPT 97597

Five similar codes to CPT 97597 include:

• CPT 97598: This code is an add-on code for each additional 20 cm2 or part thereof of total wound surface area, used in conjunction with CPT 97597.
• CPT 97602: This code is used for nonselective debridement of wounds without anesthesia, including topical applications, wound assessment, and instructions for ongoing care.
• CPT 11000: This code is used for debridement of extensive eczematous or infected skin, which differentiates from CPT 97597’s focus on open wounds.
• CPT 11042: This code is used for debridement of subcutaneous tissue, which is a deeper level of tissue than the focus of CPT 97597.
• CPT 11044: This code is used for debridement of bone, which is a more invasive procedure than CPT 97597.

10. Examples

Here are 10 detailed examples of CPT code 97597 procedures:

1. A patient with a 15 cm2 diabetic foot ulcer requiring sharp debridement with a scalpel and topical antibiotic application.
2. A patient with a 10 cm2 pressure ulcer on the sacrum, treated with high-pressure waterjet debridement and wound assessment.
3. A patient with a 20 cm2 venous leg ulcer requiring sharp debridement using scissors and forceps, followed by a whirlpool treatment.
4. A patient with a 5 cm2 traumatic wound on the forearm, treated with high-pressure waterjet debridement with suction and topical application of a wound dressing.
5. A patient with a 12 cm2 burn wound on the thigh, requiring sharp debridement with a scalpel and instructions for ongoing care.
6. A patient with an 8 cm2 post-surgical wound infection, treated with high-pressure waterjet debridement and wound assessment.
7. A patient with a 18 cm2 non-healing wound on the lower leg, requiring sharp debridement using forceps and topical application of a growth factor.
8. A patient with a 7 cm2 laceration on the hand, treated with high-pressure waterjet debridement and whirlpool treatment.
9. A patient with a 14 cm2 chronic wound on the ankle, requiring sharp debridement with scissors and wound assessment.
10. A patient with a 20 cm2 abrasion on the back, treated with high-pressure waterjet debridement with suction and instructions for ongoing care.