Health Information Management

Q/A: Reporting negative pressure therapy

APCs Insider, January 27, 2012

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 Q: The new guidelines for the integumentary system section state that CPT® codes 15002–15005 are noted to be reportable for surgical preparation of the site, including for negative pressure wound therapy. Please explain how to use these codes when reporting negative pressure wound therapy? This may affect how we report certain wound care services that we provide.

A: The 2012 CPT® Manual includes a new subheading, “Skin Replacement Surgery” that includes definitions for surgical preparation codes 15002–15005.

The AMA expanded the instructions in 2011 to include negative pressure wound therapy and further defined the instructions for 2012. The 15002–15005 code range denotes the initial preparation of a wound site to create a clean and viable surface for skin graft placement or for negative pressure wound therapy.

CPT codes 15002–15005 may be reported in addition to the codes for skin grafting and negative wound therapy when the intent is for the wound to heal by primary intention. Do not report these codes if a wound is left to heal by secondary intention.

Negative pressure wound therapy, also known as a wound vac, plays an important role in treating wounds. The wound vacuum applies subatmospheric pressure, either continuously or intermittently, to the surface of a wound to promote healing.

CPT code 97605 (negative pressure wound therapy) and CPT code 15002 (preparation of the wound bed) do not trigger a National Correct Coding Initiative (NCCI) Edit triggers. No NCCI instructions prevent reporting the codes together.

The keys to appropriate reporting are to ensure:

  • Medical necessity is met relative to NCDs or LCDs
  • Documentation is complete, includes the correct dimensions of the wound, and supports the need for wound preparation
  • Wound is meant to heal by primary intention

Providers should review the “Skin Replacement Surgery” codes in the 2012 CPT® Manual carefully and ensure that documentation clearly supports the service before assigning any codes in the 15002–15278 range.

Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.

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