How To Use CPT Code 97608

CPT 97608 describes the utilization of negative pressure wound therapy for wound care management. 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 97608?

CPT 97608 can be used to describe the application of negative pressure wound therapy for wound care management. 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 wounds that have a total surface area greater than 50 square centimeters.

2. Official Description

The official description of CPT code 97608 is: ‘Negative pressure wound therapy, 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 greater than 50 square centimeters.’

3. Procedure

1. The provider cleans and checks the wound with a total surface area greater than 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, matching the size and depth of the wound, over 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 97608 is used for wounds with a total surface area greater than 50 square centimeters that require negative pressure wound therapy. This therapy is commonly used for slow healing or nonhealing wounds, such as decubitus ulcers or pressure sores. The provider must assess the wound and determine the need for negative pressure wound therapy. The therapy should be performed by a qualified healthcare professional.

5. When to use CPT code 97608

CPT code 97608 should be used when a provider applies negative pressure wound therapy to a wound with a total surface area greater than 50 square centimeters. It is important to note that CPT code 97608 should not be reported in conjunction with CPT codes 97605 and 97606.

6. Documentation requirements

To support a claim for CPT code 97608, the provider must document the following information:

• Patient’s wound diagnosis and the need for negative pressure wound therapy
• Specific details of the therapy provided, including the type of dressing used, topical applications, and wound assessment
• Date and duration of the therapy session
• Instructions given to the patient or caregiver for ongoing wound care
• Signature of the provider performing the therapy

7. Billing guidelines

When billing for CPT code 97608, ensure that the therapy is performed on a wound with a total surface area greater than 50 square centimeters. It is important to follow the guidelines and not report CPT code 97608 in conjunction with CPT codes 97605 and 97606. Additionally, consider using modifier 26 for professional component billing and modifier TC for technical component billing, if applicable.

8. Historical information

CPT code 97608 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A provider applies negative pressure wound therapy to a patient’s decubitus ulcer with a total surface area of 75 square centimeters.
2. A wound care specialist utilizes negative pressure wound therapy for a patient with a nonhealing wound caused by a surgical incision, with a total surface area of 100 square centimeters.
3. A provider applies negative pressure wound therapy to a patient’s diabetic foot ulcer with a total surface area of 60 square centimeters.
4. A wound care nurse utilizes negative pressure wound therapy for a patient with a slow healing wound resulting from a burn, with a total surface area of 80 square centimeters.
5. A provider applies negative pressure wound therapy to a patient’s pressure sore with a total surface area of 55 square centimeters.
6. A wound care specialist utilizes negative pressure wound therapy for a patient with a nonhealing wound caused by a traumatic injury, with a total surface area of 90 square centimeters.
7. A provider applies negative pressure wound therapy to a patient’s surgical wound with a total surface area of 70 square centimeters.
8. A wound care nurse utilizes negative pressure wound therapy for a patient with a slow healing wound resulting from a vascular condition, with a total surface area of 85 square centimeters.
9. A provider applies negative pressure wound therapy to a patient’s pressure ulcer with a total surface area of 65 square centimeters.