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Most Commonly Used CPT Codes for Wound Care Billing

Wound care billing is the process of receiving payment from insurance companies for services provided to injured patients. You may have already been introduced to the concept of CPT codes. Insurance companies use these codes to determine how much a certain service should be reimbursed, and they’re typically used when billing for wound care services. However, you can use these codes in any healthcare setting that involves billing someone else for your care!  

CPT Codes For Wound Care Billing 

The most common codes used for wound care billing are:

Active Wound Care Management CPT Codes

Debridement is the removal of dead tissue in wounds. It’s usually performed by a wound care specialist, who uses sterile tools to remove granulation tissue and regenerate new skin. This can be done at home, but it requires specialized equipment and training.

CPT codes 97597, 97598, 97602, 97605, 97606, 97607, and 97608 are used for active wound care management.

  • Debridements should be classified as selective or non-selected CPT codes (97597, 97598, or 97602) unless the medical record indicates that a surgical debridement was done.
  • Dressings applied to wounds are included in the services provided by CPT codes 97597, 97598, and 97602 and may not be invoiced separately.
  • CPT code 97602 should not be reported in addition to CPT codes 97597 or 97598 for wound treatment done on the same wound on the same date of service.
  • Codes 97597, 97598, and 97602 should not be submitted with codes 11042-11047. The proper code is determined by the wound depth debrided.
  • Codes 97597-97598 are suitable when only the bacteria on the surface of a muscle ulceration is debrided. However, depending on the location, the 11043-11046 series would be appropriate for debriding muscle material.
  • 97602, 97605, 97606, 97607, and 97608 cover the application and removal of any protective or bulk dressings. These debridement codes should not be recorded if a dressing change is conducted without any active wound procedure defined by these debridement codes.
  • Whirlpools are generally included in CPT codes 97597/97598 and should not be recorded separately during the same interaction. 

Surgical Debridement’s CPT Codes 

CPT Codes 11000-11012 and 11042-11047 are used for surgical debridement.

  • Dressings applied to wounds are considered part of the service for CPT codes 11000-11012 and 11042-11047 and cannot be charged separately.

Medicare does not pay for dressing changes or wound care education for patients or caregivers. Only for services that are expected to be refused due to a lack of medical necessity can an Advance Beneficiary Notice of Non-coverage (ABN) be issued. An ABN for a dressing change is not suitable based on this data since the expenses of the dressing change are packed into other procedures billed.

  • Debridement of Necrotizing Soft Tissue Infections (CPT codes 11004-11006 and 11008) is only available as an inpatient operation.
  • CPT codes 11042, 11043, 11044, 11045, 11046, and 11047 indicate surgical removal of devitalized tissue from wounds (debridement).
  • CPT codes 11042, 11043, 11044, 11045, 11046, and 11047 indicate surgical removal of devitalized tissue from wounds (debridement).

Removing bacterial or fungal debris off feet, incision and drainage of abscesses including paronychia, nail trimming or debridement, avulsion of nail plates, acne surgery, wart removal, or burn debridement are all inappropriate uses of CPT codes 11042-11047. When these procedures constitute covered, reasonable, and necessary services, report them using the CPT/HCPCS code that best characterizes the service provided.

The CPT standards guide reporting single wound debridements (CPT codes 11042-11047) at distinct layers in different sections of the wound and wound debridement at the same and separate levels. The depth recorded for a particular wound is the most deeply removed tissue. When two or more wounds are debrided at the same depth, the surface areas of the wounds are merged. Surface regions are not connected when the depth of debridement differs. For example, for debridement codes 11042-11047, the wound measurement should be collected when the whole wound surface is debrided. Report the area that was debrided when only a piece of a wound surface is debrided. It would be inappropriate to report that code if the surface area, depth, and measurement specified in the code descriptor were not completed.

The debrided tissue level (e.g., skin, subcutaneous tissue, muscle, and bone) should be reflected in the CPT code, not the extent, depth, or grade of the ulcer or lesion.

  • CPT code 11042, “debridement, subcutaneous tissue,” should be used if only necrotic subcutaneous tissue is debrided, even if the ulcer or incision extends to the bone. Furthermore, if just fibrin is eliminated, this code is not billable.
  • Tissue debridement in the surgical field of another musculoskeletal surgery is not reportable separately. On the other hand, debridement of tissue at the site of an open fracture or dislocation can be documented independently using CPT codes 11010-11012.
  • Debridement of muscle and bone (CPT codes 11043-11044, 11046-11047) and removing a bone tumor are not independently reportable.
  • Similarly, tissue debridement CPT codes 11042, 11045, 11720-11721, 97597, and 97598 in the surgical field of a musculoskeletal operation are not separately reportable.

The type and amount of tissue removed during the surgery and the depth, size, or other parameters of the wound should be reflected in the debridement code submitted. Documentation must include when billing the debridement operation defined by CPT code 11044 to prove the depth of debridement.

  • CPT code 11044 cannot be charged if a wound has exposed bone, but the debridement process did not remove the bone.
  • 7597 is used for billing for wound care services. This includes debridement, slough removal, and wound trimming.


We hope you found this article useful. If you want to learn more about what the codes should look like, check out our article on CPT codes for wound care billing.

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