Payment and Documentation Flashcards
1
Q
How is does acute care reimbursement work?
A
Through diagnosis related groups and all pt care is included
2
Q
What is the code for active wound care < 20 cm2?
A
97597
3
Q
What does code 97597 cover?
A
- Active wound care
- Cleansing and debridement of wounds, assessment, dressing application, pt. instructions
4
Q
What is the code for active wound care > 20 cm2?
A
97598
5
Q
What does code 97598 cover?
A
- Add on code that covers same things in code 97597 for larger wounds
- Can be billed more than once per session and is billed in 20 cm2 increments
- Not therapy only codes, time coded, or labor or product specific
6
Q
What are codes 97597 and 97598 mainly used for?
A
- Debridement
- Topical applications of dressing
- Wound assessment
- Pt instructions
7
Q
How are charges per session determined?
A
Total surface area of the wounds treated during a single treatment session
8
Q
How will billing work if one wound is 10 cm2 and the second wound is 8 cm2?
A
The total surface area is 18 cm2, so it will be coded 97597
9
Q
How will billing work if one wound is 40 cm2 and the second wound is 28 cm2?
A
- The total surface area is 68 cm2
- 97597 for 0-20 cm2
- 97598 for 21 – 40 cm2
- 97598 for 41 – 60 cm2
- 97598 for 61 – 68 cm2
- Charge = 97597 (1) and 97598 (3)
