Comments on: A snapshot of RACs today and a glimpse of what lies ahead

By: Andrea Kraynak, CPC-A

Andrea Kraynak, CPC-A — Thu, 05 Feb 2009 15:09:44 +0000

I would refer the you to the June 2005 issue of CPT Assistant, pages 1 and 10, for information on this topic.

Editor’s note: This response comes from Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA, chair of Allied Health Department at Herzing College in Winter Park, FL.

By: Andrea Kraynak, CPC-A

Andrea Kraynak, CPC-A — Thu, 05 Feb 2009 15:06:32 +0000

I am not sure what you mean by a “time-out,” but below is Medicare’s LCD on debridement as far as what is allowed.

Per Medicare’s LCD codes 97597 and 97598 must be billed with the appropriate modifier (GN,GO,GP). Can only be used once per treatment session, regardless of the number of different types of selective debridement utilized. Selective debridement should be done under the specific order of a physician.

Debridements of the wounds(s), if indicated, must be performed judisciously and at appropriate intervals. Medicare expects that with appropriate care, wound volume or surface dimension should decrease by at least 10% per month or wounds will demonstrate margin advancement of no less than 1mm/week. Medicare expects the wound care treatment plan to be modified in the event that appropriate healing is not achieved.

I hope this answers the question. If not please let me know what you mean by time out.

Editor’s note: This answer was provided by Denise Nash, senior consultant with Accuro Pricing Solutions in Dallas, a MedAssets Company.

By: Carolyn Cowart

Carolyn Cowart — Thu, 29 Jan 2009 21:34:13 +0000

Could you tell me if a “Time-Out” is required when a physical therapist performs Sharps Debridement? (97597 Removal of devitalized tissue from wound(s) by selective debridement, with waterjet, scissors, scalpel & forceps, and includes whirlpool) Thank you for your assistance. Carolyn