Exam 3 Flashcards
Most codes for wound care begin with:
97xxx
What are the clinical indicators for wound care?
Slow to heal wounds
Significant health factors that impair recovery
Multiple, severe, or extensive wounds
Increasing severity of tissue impairment, infection, necrosis, undermining or increased size
Complexity and sophistication of intervention
According to the LCD, which interventions can be provided by a non-skilled person?
Topical medication
Lovage
Whirlpool
Dressings
What functional G-code should you use with wound care?
Other; you may also use CH as the modifier
The PUSH tool does not account for:
Depth
Reimbursement in the acute care setting:
DRGs
Reimbursement in the SNF setting:
RUGs
Reimbursement in a rehab hospital
FRGs
Reimbursement in home health:
HHUGs
In the outpatient setting, wounds must:
- caused by or treated by a surgical procedure
- require debridement
- burns treated by skin grafting
- catheter entry points EXCEPT infusion pumps
Non-qualifying wounds
Skin condition treated with topical medication Draining cutaneous fistula Healed wound First degree wound Skin tear or abrasion Venipuncture or arterial puncture site
Code for debridement
97597; covers debridement and associated dressings, covers the first 20 square cm or less.
97598
Code for each additional 20 square cm of wound
It is unusual to debridement for:
More than 1x per week or for longer than 3 mos
Non-selective debridement
97602 - not paid by CMS
Documentation for active wounds must include:
Current size, depth, presence and extent of or absence of obvious signs of infection, presence and extent of or absence of necrotic, tissue
Measure changes in:
Drainage Inflammation Swelling Pain Wound dimensions Necrotic tissue
Electrical stimulation is reimbursed when:
For chronic wounds if there is no measurable signs of improvement for at least 30 days of standard wound care
Before applying a NPWT, what should be considered before applying?
- patients medical record
- wound measurements
- application of dressings to maintain a moist environment
- debridement of any necrotic tissue
- evaluation of and provision for adequate nutritional status
