Hi Michael,
Thank you for the question.
DEBRIDEMENT is indicated for any wound requiring removal of deep seated foreign material, devitalized or nonviable tissue at the level of skin, subcutaneous tissue, fascia, muscle or bone, to promote optimal wound healing or to prepare the site of appropriate surgical intervention.
DEBRIDEMENT techniques include, among others, sharp and blunt dissection, curettement, scrubbing, and forceful irrigation. Surgical instruments may include a scrub brush, irrigation device, electrocautery, laser, sharp curette, forceps, scissors, burr or scalpel.
The wound care performed must be in accordance with accepted standards of medical practice. If DEBRIDEMENT is performed, the type of DEBRIDEMENT should be appropriate to the type of wound and the devitalized tissue, and the patient’s condition.
Therapists should choose the tool that best suits the wound tissue that is to be removed. Many of the providers with whom I have worked, prefer the curette when performing selective debridements. CPT codes 97597 and 97598 should be used for DEBRIDEMENT of superficial ulcers (skin, dermis and/or epidermis, whenever necrotic tissue is present in an open wound. These services will not be considered a reasonable and necessary procedure for a wound that is clean and free of necrotic tissue. However, when performing deeper debridements into the subq, muscle etc. (CPT-11042-11047), our providers preferred to use a scalpel. Sometimes both are useful. I have included the link to your Local Coverage Determination for debridement. Please let me know if I have answered this question to your satisfaction.
https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=33614&ver=11&SearchType=Advanced&CoverageSelection=Both&NCSelection=NCA%7cCAL%7cNCD%7cMEDCAC%7cTA%7cMCD&ArticleType=SAD%7cEd&PolicyType=Both&s=-%7c9&KeyWord=Debridement&KeyWordLookUp=Doc&KeyWordSearchType=Exact&kq=true&bc=IAAAACAAAAAA&Thank you,
Tiffany Hamm, BSN, ACHRN, CWS
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