CPT 97601, 97602 - Not covered CPT codes

97601 this code has been deleted, to report use 97597 or 97598

97602 Removal of devitalized tissue from wound(s), non-selective debridement without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion) including topical application(s), wound assessment, and instruction(s) for ongoing care, per session

97605 Negative pressure wound therapy (e.g., vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters

97606 total wound(s) surface are greater than 50 square centimeters


NOTE: These three codes (97602, 97605, 97606) are “bundled” services and not separately payable by Medicare or billable to the patient. 



NONCOVERED MEDICAID PROCEDURE CODES

Per the November/December 2001  Medicaid Bulletin # 159, page 4, "Effective for dates of service on or after April 1, 2001, the following procedure codes have been designated by the Texas Health & Human Services Commission (HHSC) as not a payable benefit of the Medicaid program. These guidelines are effective for claims in process on or after December 1, 2001.

�  97601- Removal of devitalized tissue from wound, selected debridement, without anesthesia (for example high pressure waterjet, sharp selective debridement with scissors, scapula and tweezers), including topical applications, wound assessment, and instruction(s) for ongoing care, per session.

 � 97602  Removal of devitalized tissue from wound; non-selective debridement, without anesthesia (for example, wet-to-moist dressings, enzymatic, abrasion), including topical application(s); wound assessment, and instruction(s) for ongoing care, per session.

MODIFIER OF THE MONTH

According to the American Medical Association definition in the 2001 CPT book, modifier -78 is appropriate in the following surgical situation. Return to the Operating Room for a Related Procedure During the Postoperative Period: The physician may need to indicate that another procedure was performed during the postoperative period of the initial procedure. When this subsequent procedure is related to the first, and requires the use of the operating room, it may be reported by adding the modifier

� 78 to the related procedure, or by using the separate five digit modifier 09978. (For repeat procedures on the same day. Many coders are confused as to when to use the modifier

� 58 (staged procedure) and when to use modifier -78. Staged procedures are intended to be completed in two or more sessions. Procedures using modifier -78 are completed in a single session. Intent is also important when selecting the most appropriate modifier. Modifier 78 is used when a subsequent procedure is unexpectedly scheduled. If the surgery is planned, modifier 58 is used. Cases involving modifier 78 involve a complication from the first surgery that requires a second procedure to treat the patient.