Negative pressure wound therapy is a wound dressing system that utilizes a vacuum assisted drainage collection device that drains the wound. The negative pressure created by the vacuum stimulates the wound bed, improves oxygenation and promotes healing of open wounds.
Codes 97605 and 97606 are used to report negative wound pressure therapy services utilizing devices that are typically based in a facility or office and referred to as durable medical equipment (DME) because of their reusable nature. These devices are usually electronically powered, meaning they are plugged into an external electrical source, usually an outlet.
Codes 97607 and 97608 are used to report negative pressure wound therapy that is provided using disposable devices such as mechanically powered devices, typically battery operated. These types of devices are not considered DME because of their disposable nature.
Documentation will often include mention of foam application, usually by foam color such as black, white and blue, however, the type of foam used does not affect the code selection.
Here are some key documentation points for correct billing of NPWT:
- All NPWT services require direct (one-on-one) contact with the patient.
- NPWT services are billed by total wound surface area, therefore size should be documented:
- 97605 and 97607 are for wounds < 50 square centimeters
- 97606 and 97608 are for wounds >50 square centimeters
- Documentation should include the type of equipment used:
- DME or
- non-DME (disposable)
- Documentation should state that the NPWT was placed at an open wound site.
A common error seen when billing for these services is that they are billed when placed on an operative incision that has been surgically closed, in which case it is considered a dressing and not separately reportable.
Some examples of types of wounds that may be treated with NPWT include, but are not limited to the following:
- Chronic wounds such as diabetic foot ulcers, venous ulcers and pressure ulcers
- Traumatic/acute wounds that have not been repaired
- Partial-thickness burns
Codes for NPWT (97605-97608) bundle with many other procedures - always check NCCI edits before reporting!
2020 AMA CPT Professional
CPT Assistant November 2014, Volume 24, Issue 11
2020 NCCI Chapter I, General Correct Coding Policies
Deanna Upston, CPMA, CPC, COSC