What Is the CPT Code for Wound Care?

Wound care includes a variety of procedures designed to promote healing, prevent infection, and manage chronic or acute wounds. Proper CPT coding is essential for accurate billing, compliance, and timely reimbursement. This guide breaks down the most commonly used CPT codes for wound care and provides insights on when to use them.

Understanding CPT Codes in Wound Care

Current Procedural Terminology (CPT) codes are standardized codes developed by the American Medical Association (AMA) to describe medical, surgical, and diagnostic services. Accurate coding helps:

• Ensure proper reimbursement
• Reduce claim denials
• Maintain regulatory compliance

To understand how CPT codes integrate into broader billing processes, see our guide on orthopedic medical billing.

Common CPT Codes for Wound Care

1. Debridement Codes

Debridement removes necrotic or devitalized tissue from a wound, which promotes healing. The CPT code depends on the depth and type of tissue removed:

• Selective debridement:
  • 97597 – Debridement of open wound(s), including topical application(s) and wound assessment.
  • 97598 – Each additional 20 sq cm.
• Surgical debridement:
  • 11042–11047 – Surgical removal of devitalized tissue, depending on tissue depth.

 Codes for selective debridement should not be reported with surgical debridement codes for the same wound on the same day.

2. Active Wound Care Management Codes

These codes apply to negative pressure wound therapy (NPWT) or application of advanced dressings:

• 97605 – NPWT using a pump for a wound.
• 97606 – NPWT for an additional wound.
• 97607 – Application of skin substitute grafts.
• 97608 – Skin substitute application for an additional wound.

Learn more about how wound care billing integrates in clinical practices like gastroenterology in our gastroenterology medical billing guide.

3. Skin Substitute Codes

When biological or synthetic skin substitutes are applied:

• 15271–15275 – Application of skin substitute grafts to wounds, based on the depth of tissue replaced.

These codes cover materials used to accelerate wound healing.

Evaluation and Management (E/M) Codes

For patient visits related to wound care:

• New Patients: 99202–99205
• Established Patients: 99212–99215

The code depends on the complexity of the visit and services provided. For imaging or diagnostics accompanying wound assessment, see our radiology billing guide.

Modifiers and Bundling Rules

When multiple procedures are performed, modifiers indicate changes in service:

• Modifier 59 – Distinct procedural service
• Modifier 76 – Repeat procedure by same provider
• Modifier 51 – Multiple procedures

Proper use ensures claims are processed correctly and prevents denials.

Why Accurate Coding Matters

Correct CPT coding for wound care ensures:

• Timely reimbursement
• Fewer denials
• Compliance with payer regulations

For detailed coding and reimbursement guidelines, refer to the CMS official resource on wound care.

Final Thoughts

Accurate CPT coding for wound care ensures proper reimbursement, reduces claim denials, and supports compliance. Using the correct codes for debridement, skin substitutes, and patient visits helps streamline billing and improve patient care. For best practices, refer to resources like CMS and specialized billing guides for orthopedic, gastroenterology, and radiology services.