Documentation measured in centimetres
Wound care is a service line provided by physicians, podiatrists and advanced practice providers in hospital-based clinics, offices and nursing facilities. Its codes depend on measurements — depth of tissue removed, surface area treated, size of graft applied — so the wound note has to record exact dimensions and progress at every visit. Payers watch high-cost wound products closely, and Medicare changed how it pays for skin substitutes in 2026.
Debridement
| Type | Codes | Based on |
|---|---|---|
| Surgical debridement | 11042–11047 | Deepest tissue removed (subcutaneous, muscle/fascia, bone) and surface area: first 20 sq cm plus each additional 20 sq cm |
| Selective debridement (active wound care) | 97597, 97598 | Surface area; removal of specific devitalized tissue without anesthesia |
| Non-selective debridement | 97602 | Per session; often bundled when another debridement is billed |
When several wounds are debrided to the same depth, their surface areas are added together; wounds debrided to different depths are coded separately. The note records the instrument used, tissue removed, depth reached and measurements before and after.
Skin substitutes and grafts
- Application is coded by wound location and total area (15271–15278 for skin substitute grafts), separately from the product.
- Products are billed with their HCPCS Q-codes. Since January 2026, Medicare pays most skin substitute products in offices and hospital outpatient departments as supplies at a single rate per square centimetre, instead of product-specific prices; true biologicals are the exception.
- Medicare contractors withdrew the skin substitute coverage determinations for diabetic foot and venous leg ulcers in December 2025, so documentation of failed standard care and wound progress remains the basis for coverage and audits.
- Wastage of graft material is reported as each payer requires.
Compression, hyperbaric oxygen and the setting
Multi-layer compression for venous ulcers (29581) and unna boots (29580) are billed per application when not part of a same-day debridement. Hyperbaric oxygen therapy is covered only for listed conditions, such as certain diabetic foot ulcers that have not responded to standard care, with physician supervision billed per session (G0277 for the facility and 99183 for the physician). Wound clinics in hospital outpatient departments bill a facility claim in addition to the professional claim. Many commercial plans require prior authorization for skin substitutes and hyperbaric oxygen.