Non-selective debridement of wounds, per session

Description

This service involves the removal of non-viable tissue from wounds to facilitate healing and minimize infection risk. It is billed for each session of debridement and includes guidance for appropriate wound care management for the patient.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

$198.70

Calculation:

x=$198.70

Patient Copayment / Coinsurance

$39.74

Calculation breakdown:

Minimum (20% of rate)$39.74

Top Modifiers

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HCPCS/CPT 59Distinct procedural service for non-E/M services(19.02%)

HCPCS/CPT GPOutpatient physical therapy service delivered by a physical therapist(5.18%)

HCPCS/CPT GOOutpatient occupational therapy service delivered by an occupational therapist(3.44%)

HCPCS/CPT LTModifier for procedures performed on the left side of the body(2.73%)

HCPCS/CPT XUUnusual non-overlapping service(2.64%)

HCPCS/CPT RTRight side procedure modifier(2.4%)

HCPCS/CPT KXDocumentation requirements met for DMEPOS items(1.88%)

HCPCS/CPT XSSeparate structure service on distinct organ or structure(1.88%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(1.41%)

HCPCS/CPT 58Staged or related procedure by the same physician during postoperative period(1.22%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)