How To Use CPT Code 97607

CPT 97607 describes the application of negative pressure wound therapy for wounds with a total surface area less than or equal to 50 square centimeters. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 97607?

CPT 97607 can be used to describe the application of negative pressure wound therapy for wounds with a total surface area less than or equal to 50 square centimeters. This code is used when a provider applies controlled subatmospheric pressure around a wound through a sealed dressing to remove fluids and infectious materials, and to aid in the healing process of slow healing or nonhealing wounds.

2. Official Description

The official description of CPT code 97607 is: ‘Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters.’

3. Procedure

1. The provider cleans and checks the wound with a total surface area less than or equal to 50 square centimeters for the presence or absence of sinus tracts and fistulas.
2. If no sinus tracts or fistulas are present, the provider attaches a foam sponge over the wound, matching the size and depth of the wound, and covers it with a transparent film to create a tight seal.
3. The provider inserts disposable medical tubing into the dressing through an opening in the transparent film and connects it to a negative pressure pump.
4. The provider activates the pump, which applies controlled subatmospheric pressure to the wound, aiding in the removal of fluids and infectious materials.
5. During the therapy, the provider observes the patient for any signs of distress and ensures the proper functioning of the equipment.
6. The provider may need to replace the canister in which the suctioned material accumulates.
7. The provider also provides instructions to the patient or caregiver on how to provide ongoing care for the wound.

4. Qualifying circumstances

CPT 97607 is used for wounds with a total surface area less than or equal to 50 square centimeters that require negative pressure wound therapy. This therapy can be used to hasten the healing of various types of wounds, including decubitus ulcers or pressure sores. The provider must assess the wound and determine the need for negative pressure wound therapy. The therapy is typically provided by a healthcare professional who is trained in wound care management.

5. When to use CPT code 97607

CPT code 97607 should be used when a provider applies negative pressure wound therapy to a wound with a total surface area less than or equal to 50 square centimeters. It is important to note that this code is not appropriate for wounds with a larger surface area, for which a different code, such as CPT 97608, should be used.

6. Documentation requirements

To support a claim for CPT code 97607, the provider must document the following information:

• The diagnosis of the wound and the need for negative pressure wound therapy
• The specific wound assessment, including the presence or absence of sinus tracts and fistulas
• The type of dressing used, such as a foam sponge and transparent film
• The start and end time of the therapy session
• Any observations or complications during the therapy session
• Instructions provided to the patient or caregiver for ongoing wound care
• The provider’s signature

7. Billing guidelines

When billing for CPT code 97607, ensure that the wound has a total surface area less than or equal to 50 square centimeters. It is important to follow the specific guidelines for negative pressure wound therapy and document the necessary information. Additionally, be aware of any specific coding requirements or modifiers that may be necessary for accurate billing.

8. Historical information

CPT code 97607 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider applies negative pressure wound therapy to a small surgical wound with a total surface area of 20 square centimeters.
2. A patient with a diabetic foot ulcer receives negative pressure wound therapy for a wound with a total surface area of 40 square centimeters.
3. A provider uses negative pressure wound therapy to aid in the healing of a pressure sore with a total surface area of 30 square centimeters.
4. A patient with a traumatic wound receives negative pressure wound therapy for a wound with a total surface area of 50 square centimeters.
5. A provider applies negative pressure wound therapy to a small burn wound with a total surface area of 15 square centimeters.
6. A patient with a surgical incision receives negative pressure wound therapy for a wound with a total surface area of 25 square centimeters.
7. A provider uses negative pressure wound therapy to aid in the healing of a venous ulcer with a total surface area of 35 square centimeters.