Guest guest Posted January 20, 2011 Report Share Posted January 20, 2011 Good morning. Is anyone providing pulsed lavage in conjunction with sharps debridement in their outpatient facility? Our wound center is looking to possibly have PT add this as a service as an adjunct to physician debridement, however I am wondering if pulsed lavage is the only treatment being provided by the therapist can the debridement charge be billed (as it is a form of mechanical debridement) if the physician is doing the debridement and dressing changes. Just wondering if anyone has any experience with this and the reimbursement involved with billing this procedure. Thank you for any input you are able to offer. Tara Shank Bellin Hospital Green Bay WI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 It's been a number of years but we got away from it as the fan tips, etc. were costing more than the reimbursement. Once Katrina hit, and we lost the machine, we never considered going back to it. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc. Bay St. Louis and Diamondhead, Mississippi Pulsed Lavage Good morning. Is anyone providing pulsed lavage in conjunction with sharps debridement in their outpatient facility? Our wound center is looking to possibly have PT add this as a service as an adjunct to physician debridement, however I am wondering if pulsed lavage is the only treatment being provided by the therapist can the debridement charge be billed (as it is a form of mechanical debridement) if the physician is doing the debridement and dressing changes. Just wondering if anyone has any experience with this and the reimbursement involved with billing this procedure. Thank you for any input you are able to offer. Tara Shank Bellin Hospital Green Bay WI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 Tara, Both Pulsed Lavage (pulsavac) and sharp debridement fall under the Selective Debridement description (CPT 97597/97598). Most LCDs specifically states that as they are not a timed code you can only bill one unit per visit. You certainly can do both but you can only bill and get reimbursement for one. With regard to surgical (physician) debridement, CPT codes 11042-11047, the same rule applies in that Medicare will not accept billing nor reimburse for both a 97597 (selective debridement/pulsed lavage) and the above codes/procedures on the same day. You may want to check on whether or not you can bill a clinic visit/E & M charge and a selective debridement on the same visit but unless I am mistaken I believe Medicare does not allow this as well. I hope this helps you. Jeff Brown PT Decatur Memorial Hospital Rehab Decatur, IL >>> 1/26/2011 1:21 PM >>> It's been a number of years but we got away from it as the fan tips, etc. were costing more than the reimbursement. Once Katrina hit, and we lost the machine, we never considered going back to it. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc. Bay St. Louis and Diamondhead, Mississippi Pulsed Lavage Good morning. Is anyone providing pulsed lavage in conjunction with sharps debridement in their outpatient facility? Our wound center is looking to possibly have PT add this as a service as an adjunct to physician debridement, however I am wondering if pulsed lavage is the only treatment being provided by the therapist can the debridement charge be billed (as it is a form of mechanical debridement) if the physician is doing the debridement and dressing changes. Just wondering if anyone has any experience with this and the reimbursement involved with billing this procedure. Thank you for any input you are able to offer. Tara Shank Bellin Hospital Green Bay WI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 Tara, Both Pulsed Lavage (pulsavac) and sharp debridement fall under the Selective Debridement description (CPT 97597/97598). Most LCDs specifically states that as they are not a timed code you can only bill one unit per visit. You certainly can do both but you can only bill and get reimbursement for one. With regard to surgical (physician) debridement, CPT codes 11042-11047, the same rule applies in that Medicare will not accept billing nor reimburse for both a 97597 (selective debridement/pulsed lavage) and the above codes/procedures on the same day. You may want to check on whether or not you can bill a clinic visit/E & M charge and a selective debridement on the same visit but unless I am mistaken I believe Medicare does not allow this as well. I hope this helps you. Jeff Brown PT Decatur Memorial Hospital Rehab Decatur, IL >>> 1/26/2011 1:21 PM >>> It's been a number of years but we got away from it as the fan tips, etc. were costing more than the reimbursement. Once Katrina hit, and we lost the machine, we never considered going back to it. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc. Bay St. Louis and Diamondhead, Mississippi Pulsed Lavage Good morning. Is anyone providing pulsed lavage in conjunction with sharps debridement in their outpatient facility? Our wound center is looking to possibly have PT add this as a service as an adjunct to physician debridement, however I am wondering if pulsed lavage is the only treatment being provided by the therapist can the debridement charge be billed (as it is a form of mechanical debridement) if the physician is doing the debridement and dressing changes. Just wondering if anyone has any experience with this and the reimbursement involved with billing this procedure. Thank you for any input you are able to offer. Tara Shank Bellin Hospital Green Bay WI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2011 Report Share Posted January 27, 2011 Please note that the CPT coding for debridement recently changed whereby, for wounds larger than 20cm, it is appropriate to bill more than 1 CPT code per visit. 97597 is billed as a single charge for all wounds <20 cm as previously. However, we used to bill 97598 instead of 97597 for wounds >20cm but now the CPT coding definition is to bill an additional 97598 for each 20cm increment of wound size. For example a wound 55cm in size that is derided would be billed as (1) 97597 and (2) 97598. The reimbursement value for 97598 has decreased greatly with this new coding so it is essential to use the correct coding. Ron Sent from my iPad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2011 Report Share Posted January 28, 2011 I apologize that with the previous post I did not cite my source. As is often the case when researching these issues you will find conflicting information. The info I stated is from the Federal Register Vol. 76, No. 7 Rules and Regulations dated January 11, 2011 which appears to be the most up to date information. I would encourage you to research for yourself, as we did, before changing your billing practices. Sent from my iPad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2011 Report Share Posted January 28, 2011 I apologize that with the previous post I did not cite my source. As is often the case when researching these issues you will find conflicting information. The info I stated is from the Federal Register Vol. 76, No. 7 Rules and Regulations dated January 11, 2011 which appears to be the most up to date information. I would encourage you to research for yourself, as we did, before changing your billing practices. Sent from my iPad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2011 Report Share Posted January 28, 2011 I apologize that with the previous post I did not cite my source. As is often the case when researching these issues you will find conflicting information. The info I stated is from the Federal Register Vol. 76, No. 7 Rules and Regulations dated January 11, 2011 which appears to be the most up to date information. I would encourage you to research for yourself, as we did, before changing your billing practices. Sent from my iPad Quote Link to comment Share on other sites More sharing options...
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