Arobella Medical - Sound Touch for Wound Care™

Qoustic Wound Therapy System™ Reimbursement

The Qoustic Wound Therapy System™ can be used in any site of service for the "selective dissection and fragmentation of tissues, wound debridement (acute and chronic wounds, burns, diseased or necrotic tissue), and the cleansing irrigation of the site for the removal of debris, exudates, fragments, and other matter through the use of ultrasonic energy and/or fluid irrigation."1

The 11000 series of codes may be used to report the surgical debridement of a wound and are differentiated by either the percent of body area treated (11000-11001) or the type of tissue removed (11040-11044). The 97000 series of codes are used to report the debridement of a wound as well as the management of the wound that may or may not include wound assessment, wound care instructions and the use of a whirlpool. The 97000 series of codes include both selective debridement (97597-97598) and non-selective debridement (97602).

Providers are solely responsible for all coding decisions, documentation and requests for payment. Individual payer requirements can vary. Coding and documentation requirements can also vary over time. The Provider is solely responsible for keeping current with all payer requirements and codes. Arobella Medical is not responsible for any specific coding decision or request for payment.


Debridement Performed in the Physician Office2


CPT Code3 Description 2008 Medicare National Average Payment Rate Non Facility
Surgical Debridement
11000 Debridement of extensive eczematous or infected skin; up to 10% of body surface $47.55
11001 Debridement of extensive eczematous or infected skin; each additional 10% of the body surface (List separately in addition to code for primary procedure) $20.35
11040 Debridement; skin, partial thickness $41.91
11041 Debridement; skin, full thickness $50.21
11042 Debridement; skin, and subcutaneous tissue $68.35
11043 Debridement; skin, subcutaneous tissue, and muscle $245.17
11044 Debridement; skin, subcutaneous tissue, muscle, and bone $330.95
Active Wound Care Management
97597 Removal of devitalized tissue from wound(s), selective debridement, without anesthesia (e.g., high pressure water jet with/without suction, sharp selective debridement with scissors, scalpel and forceps), with or without topical application(s), wound assessment, and instruction(s) for ongoing care, may include use of a whirlpool, per session; total wound(s) surface area less than or equal to 20 square centimeters $54.87
97598 Removal of devitalized tissue from wound(s), total wound(s) surface area greater than 20 square centimeters $67.97
97602 Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for on going care, per session NA, bundled code, not paid separately
17999 Unlisted procedure, skin, mucous membrane and subcutaneous tissue Carrier determined

Debridement Performed in the Outpatient Facility


CPT Code3 Description APC Assign- ment 2008 Medicare National Average Payment Rate for Physician and Facility
Surgical Debridement
11000 Debridement of extensive eczematous or infected skin; up to 10% of body surface 0013 $30.03/$50.51
11001 Debridement of extensive eczematous or infected skin; each additional 10% of the body surface (List separately in addition to code for primary procedure) 0013 $15.39/$50.51
11040 Debridement; skin, partial thickness 0015 $25.91/$92.96
11041 Debridement; skin, full thickness 0015 $33.83/$92.96
11042 Debridement; skin, and subcutaneous tissue 0016 $44.73/$169.45
11043 Debridement; skin, subcutaneous tissue, and muscle 0016 $212.79/$169.45
11044 Debridement; skin, subcutaneous tissue, muscle, and bone 0682 $293.62/$438.32
Active Wound Care Management
97597 Removal of devitalized tissue from wound(s), selective debridement, without anesthesia (e.g., high pressure water jet with/without suction, sharp selective debridement with scissors, scalpel and forceps), with or without topical application(s), wound assessment, and instruction(s) for ongoing care, may include use of a whirlpool, per session; total wound(s) surface area less than or equal to 20 square centimeters 0015 $36.21/$92.96
97598 Removal of devitalized tissue from wound(s), total wound(s) surface area greater than 20 square centimeters 0015 $47.02/$92.96
97602 Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for on going care, per session 0015 NA, bundled code/$92.96
17999 Unlisted procedure, skin, mucous membrane and subcutaneous tissue 0012 carrier determined/$18.87

Debridement Performed in the Ambulatory Surgical Center


CPT Code3 Description 2008 Payment Indicator4 2008 Medicare National Average Payment Rate for Physician and Facility
Surgical Debridement
11042 Debridement; skin, and subcutaneous tissue A2 $44.73/$150.85
11043 Debridement; skin, subcutaneous tissue, and muscle A2 $212.79/$150.85
11044 Debridement; skin, subcutaneous tissue, muscle, and bone A2 $293.62/$388.55

1 FDA cleared labeling for the Qoustic Wound Therapy System™, K062544.
2 Payment amounts shown for Medicare National Average 2008 Physician Fee Schedules (MPFS) and Medicare Hospital Outpatient Ambulatory Payment Classification (APC) National Average Benchmarks are not a guarantee of payment.
3 Current Procedural Terminology (CPT) is copyright 2007 of the American Medical Association (AMA). All rights reserved.
4 ASC Final Rule (Federal Register Vol. 72 No. 227, November 27, 2007)

Documentation Guidelines

Providers who perform wound debridement are advised to document and maintain complete and accurate medical records for each wound care patient and procedure. The following general documentation checklist is provided for your convenience. Please note that this list is a general guideline only. Individual documentation requirements may vary. Providers are encouraged to develop their own methods of record keeping, but, at a minimum, those records should include the components outlined in the checklist.

At A Minimum, The Following Should Be Documented In The Patient Chart:

  1. Level of tissue removed
    • Skin
    • Full thickness
    • Partial thickness
    • Subcutaneous
    • Muscle
    • Bone
  2. Character of the wound
    • Before debridement
    • After debridement
  3. Medical necesity for debridement
  4. Plan of care with treatment goals
  5. Physician follow up
  6. Evidence of progres of the wound's response to treatment
    • Current wound size
    • Wound depth
    • Signs of infection
    • If present, extent of infection
    • Presence or absence of necrotic, devitalized or non-viable tissue
    • If present, extent of the diseased tissue
  7. Appropriate evaluation and management of medical conditions that may affect the course of wound healing

Note: Some payers may also require periodic evaluation of the wound (no less than every 30 days)

Reimbursement Information (PDF)