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Question: Can registered nurses (RNs) perform/bill for a debridement (CPT^庐 97597)?

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Answer: Medicare and payers following Medicare rules do not allow RNs to perform 97597 (Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less). Per Medicare local coverage article A53296, 鈥淎 physician, NPP [non-physician practitioner] or therapist acting within their scope of practice and licensure may provide debridement services鈥� billed with 97597 ().

However, Medicare policy goes on to note that 鈥渉ospital staff acting within their scope of practice and/or licensure鈥� and 鈥渟taff providing therapy services incident-to the physician treatment plan 鈥� may provide wound care, including debridement services, incident-to the services of a physician/NPP.鈥�