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Code 97602 includes wound assessment

APCs Weekly Monitor, July 21, 2006

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Code 97602 includes wound assessment

QUESTION: We recently opened a hospital-based outpatient wound care clinic and I need more information on CPT code 97602 (Nonselective wound care). I know it represents non-physician, non-selective debridement, but should we use it to report the services of staff who apply dressings that debride, such as enzymes, wet-to-moist, or wound cleaning with gauze?

If our physician as well as the nurse (RN or CWOCN) assess the patient and wound(s), but the nurse performs the wound care, is it appropriate to charge 97602 for the facility? Should the physician also charge his or her fee for assessing the wound(s)?

ANSWER: CPT code 97602 includes the wound(s) assessment.

Therefore, when a physician/non-physician practitioner evaluates the patient in a provider-based wound care clinic, report the professional E/M code for the hands-on services of the physician/non-physician practitioner. In addition, bill 97602 for the facility component of the encounter. This includes the facility portion of the physician/non-physician practitioner assessment, and the nurse execution of the wound care plan during the same visit.

If staff do not perform non-selective debridement, report an E/M code for the facility based on the hospital's E/M criteria.

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