Wound care is one of the most common—and complex—services podiatrists provide. Proper billing and coding are essential for timely reimbursement and to avoid costly denials.
Why Wound Care Billing Matters
Chronic foot wounds, diabetic ulcers, and pressure sores are time-intensive to treat. If documentation or coding is incomplete, payers may reject the claim, delaying payment for care you’ve already provided.
Key CPT Codes for Wound Care
Some of the most frequently used wound care codes in podiatry include:
- 97597 / 97598: Selective debridement (first 20 sq. cm, add-on code for each additional 20 sq. cm)
- 11042 – 11047: Excisional debridement of subcutaneous tissue, muscle, or bone
- 97602: Non-selective debridement (e.g., wet-to-dry dressings)
Documentation Best Practices
- Record wound size, depth, and location at every visit.
- Specify method of debridement (sharp, mechanical, enzymatic).
- Include before-and-after measurements to show progress.
- Attach supporting photos when possible (many payers request them).
Common Denial Reasons
- Missing wound measurements
- Inconsistent progress notes
- Lack of medical necessity documentation
How to Avoid Denials
- Use a checklist to ensure documentation is complete before claim submission.
- Scrub claims with your EMR or billing software to catch missing modifiers.
- Train staff to code based on wound depth, not just size.
Key Takeaway
Consistent documentation and correct coding are the cornerstones of successful wound care billing. A streamlined workflow helps your practice get reimbursed faster and keeps your revenue cycle healthy.
