97597

🩹 CPT 97597 — Debridement, Open Wound, First 20 Sq Cm Or Less (Selective)

Quick Reference

wRVU: 1.29 | Global Period: 000 (same day) | Assistant Payable: ❌ No | Bilateral Indicator: 3

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📋 Clinical Description

CPT 97597 describes selective debridement of an open wound with a total surface area of 20 sq cm or less per session, performed using high-pressure waterjet (with or without suction), sharp instruments (scissors, scalpel, forceps), or equivalent selective technique, to remove devitalized epidermis, dermis, fibrin, slough, exudate, biofilm, and debris — with the goal of converting a chronic, non-healing wound bed into an acute, healable wound environment. This code is distinguished from its add-on companion 97598 (each additional 20 sq cm) by the fact that 97597 is always the base unit and must be reported first; 97598 is stacked for wound surface area exceeding the initial 20 sq cm. It is critically distinct from the surgical debridement family (11042-11044) by depth: 97597 applies only when the deepest tissue removed does not extend into the subcutaneous layer — the moment fat, fascia, muscle, or bone is involved, the 11042-series drives code selection.

Non-healing open wounds requiring this level of care are wounds in which the normal healing cascade has stalled due to local or systemic factors — including diabetes, venous or arterial insufficiency, pressure injury, infection, or ischemia — resulting in accumulation of devitalized tissue, biofilm, or chronic inflammatory exudate that mechanically prevents re-epithelialization. If left untreated, stalled wounds progress to deeper tissue destruction, osteomyelitis, systemic infection, and in lower-extremity patients, risk of amputation. When the wound etiology is diabetic, the diabetic combination code (e.g., E11.621) sequences first, with the L97 site-specificity code assigned as an additional code per ICD-10-CM combination code guidelines.

This procedure may be performed in the following clinical contexts:

• Diabetic foot or lower-extremity ulcer — Neuropathic or ischemic wound in a diabetic patient requiring serial selective debridement to stimulate the wound bed and control biofilm burden, with E11.621 or E11.622 driving the primary diagnosis
• Venous stasis ulcer — Lower-extremity ulcer from chronic venous hypertension (I87.311/I87.312) requiring debridement of slough and fibrin as part of a compression/wound care program
• Pressure injury (stage II-unstageable) — Debridement of pressure-related skin/dermis breakdown at bony prominences (sacrum, heel, hip, buttock) coded with L89 series
• Post-surgical wound dehiscence — Disrupted surgical wound (T81.31XA initial encounter) requiring debridement to remove nonviable wound edges and re-establish clean healing tissue
• Non-pressure chronic ulcer (other sites) — Idiopathic or autoimmune-related skin ulcers (L98.491/L98.492) not attributable to diabetes, venous insufficiency, or pressure, requiring documentation of all contributing conditions to establish medical necessity

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🔬 Anatomical & Procedural Considerations

Technique Variant	Mechanism / Steps	Key Notes / Coding Impact
High-Pressure Waterjet (e.g., VersaJet™)	Pressurized saline jet simultaneously cuts and evacuates devitalized tissue via Venturi effect; precise depth control allows preservation of healthy granulation tissue	Requires specialized equipment; document device used and wound area treated; same code as manual sharp — technique does not change the CPT selection
Sharp Selective Debridement (Scissors, Scalpel, Forceps)	Provider manually excises fibrin, slough, hyperkeratotic wound edges, and necrotic epidermis/dermis layer by layer using cutting instruments at bedside or in clinic	Most common method; requires documentation that only non-viable tissue was selectively removed — operative/procedure note must describe tissue type removed and instruments used
Whirlpool / Hydrotherapy (adjunct)	Immersion or pulsed lavage to soften devitalized tissue and reduce bacterial load prior to or following sharp debridement	Code is per session and includes whirlpool when performed — do NOT separately report hydrotherapy; it is bundled into 97597
Topical Application (adjunct)	Application of antimicrobial, enzymatic, or moisture-retentive dressings or agents post-debridement	Included in the code; topical application of medications is bundled — separately reportable only when a supply or drug code (HCPCS A-code) applies to the product used, per payer policy

Clinical Pearl

The single most important documentation element for 97597 is the explicit description of what type of tissue was removed (fibrin, slough, necrotic epidermis/dermis, biofilm, debris) and the measured surface area of the wound (in square centimeters). Without a documented wound size and tissue type, the claim is vulnerable to denial or downcode. Additionally, 97597 is billed per session — if the clinician debrided three separate wounds totaling 35 sq cm in one visit, you would report 97597 (first 20 sq cm) + one unit of add-on 97598 (the additional 15 sq cm), not three units of 97597.

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✅ Procedure Includes

• Pre-procedure wound assessment including wound bed description, periwound skin condition, dimensions, and exudate characteristics
• Selective removal of devitalized tissue including fibrin, slough, necrotic epidermis and/or dermis, exudate, debris, and biofilm
• High-pressure waterjet, sharp instrument technique (scissors, scalpel, forceps), or equivalent selective modality
• Use of whirlpool or hydrotherapy when performed during the same session
• Topical application(s) of wound care agents, antimicrobials, or dressings applied post-debridement
• Patient and/or caregiver instructions for ongoing wound care management
• Documentation of wound surface area, tissue type removed, technique used, and response to treatment

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❌ Excludes / Do Not Report Together

Code	Description	Relationship to 97597
97598	Debridement, open wound; each additional 20 sq cm, or part thereof	Add-on to 97597 — never report 97598 without 97597 as the base code; use for wound surface area exceeding the first 20 sq cm in the same session
11042	Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less	Mutually exclusive with 97597 when debridement reaches subcutaneous fat or deeper — code selection is driven by the deepest tissue layer removed, not wound depth; if fat is exposed and removed, 11042 replaces 97597
11043	Debridement, muscle and/or fascia; first 20 sq cm or less	Select over 97597 when muscle or fascia is debrided; 11043 subsumes any epidermal/dermal component
11044	Debridement, bone; first 20 sq cm or less	Select over 97597 when bone is debrided; 11044 subsumes all shallower tissue layers
97602	Wound(s), non-selective debridement, without anesthesia; first 20 sq cm or less	Non-selective (mechanical/enzymatic/autolytic) debridement — mutually exclusive with 97597 at the same wound site same session; 97597 = selective (sharp), 97602 = non-selective (wet-to-dry, enzymatic)
E/M codes (992xx / 920xx)	Office visit, any level	Separately reportable only when modifier -25 is appended to the E/M code, documenting a significant, separately identifiable E/M service beyond the routine pre-procedure wound assessment

Bundling Alert — Global Period is 000, Not 010 or 090

CPT 97597 carries a 000-day (same-day) global period, meaning only services provided on the day of the procedure itself are bundled into the surgical package. Follow-up wound care visits on subsequent days are separately billable. This is a critical distinction from the 10- and 90-day global periods that apply to the surgical debridement family (11042-11044). The most common audit finding is billing a separate E/M on the same day as 97597 without modifier -25 on the E/M — if a medically necessary, separately identifiable evaluation occurred beyond the pre-procedure assessment, modifier -25 must be appended to the E/M code (not to 97597) and the note must reflect two distinct services.

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🌳 Code Tree — Medicine: Active Wound Care Management

CPT 97597-97610 Active Wound Care Management
│
├── 97597-97598 Selective Debridement (Epidermis/Dermis only)
│ ├── ▶▶ 97597 ◀◀ Debridement, open wound; first 20 sq cm or less ← YOU ARE HERE (Global: 000)
│ └── +97598 Each additional 20 sq cm, or part thereof [Add-on; list separately] (Global: 000)
│
├── 97602 Non-Selective Debridement, without anesthesia; ≤20 sq cm (Global: 000)
│
└── 97605-97610 Negative Pressure Wound Therapy
├── 97605 NPWT using durable medical equipment; ≤50 sq cm (Global: 000)
├── 97606 NPWT using durable medical equipment; >50 sq cm (Global: 000)
├── 97607 NPWT using disposable device; ≤50 sq cm (Global: 000)
└── 97608 NPWT using disposable device; >50 sq cm (Global: 000)

Surgical Debridement (by depth — separate family):
├── 11042 Subcutaneous tissue, first 20 sq cm (Global: 010)
├── +11045 Each additional 20 sq cm [Add-on]
├── 11043 Muscle and/or fascia, first 20 sq cm (Global: 010)
├── +11046 Each additional 20 sq cm [Add-on]
├── 11044 Bone, first 20 sq cm (Global: 010)
└── +11047 Each additional 20 sq cm [Add-on]

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💰 RVU & Reimbursement Profile

Component	Value
Work RVU (wRVU)	1.29 (verify against CMS MPFS 2026 final rule — CMS-1832-F)
Global Period	000 (same day)
Bilateral Indicator	3 — Bilateral, no standard reduction rules applicable; each wound site is separately billable using modifier -59 or -XS
Assistant Surgeon	❌ Not payable
Co-Surgeon	❌ Not applicable
Team Surgery	❌ Not applicable
PC/TC Split	❌ No — procedure code only (Indicator 0)
Modifier -51 Exempt	No — subject to multiple procedure rules
Anesthesia	Topical or local infiltration only; no separate anesthesia billing expected for routine debridement in office/clinic setting

Bilateral Billing Rules

97597 has a bilateral indicator of 3, meaning standard Medicare bilateral payment reduction rules (the 150% rule) do not apply. When the same provider debrids wounds at multiple anatomically distinct sites in a single session, each distinct wound is reported separately using modifier -59 (or preferred NCCI modifier -XS for separate structure). The total billable surface area across all wounds in the same session determines whether add-on 97598 is needed. Always document each wound site separately in the procedure note with individual measurements to support multi-wound billing.

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🏷️ Modifier Reference

Modifier	Name	When to Apply
-25	Significant, Separately Identifiable E/M	Applied to the E/M code — not 97597 — when a separately identifiable office visit with medical decision-making beyond the wound assessment is documented on the same date; the note must reflect two distinct services
-24	Unrelated E/M During Postoperative Period	Not typically applicable given the 000-day global; however, if same-day service occurs after a prior 97597 was reported with a 000 global on the same day, documentation of a separate unrelated condition may be needed
-59	Distinct Procedural Service	Applied to subsequent units of 97597 when multiple distinct wound sites are treated in the same session; establishes that each service is at a separate anatomic site
-XS	Separate Structure	Preferred NCCI-compliant alternative to -59; documents that a second or additional debridement was performed on a structurally distinct wound
-XU	Unusual Non-Overlapping Service	When payers bundle 97597 with another wound care service inappropriately and the services are demonstrably non-overlapping
-52	Reduced Services	Debridement partially completed — document extent of tissue removed and reason for incomplete procedure
-53	Discontinued Procedure	Debridement stopped due to patient safety concern (e.g., patient intolerance, bleeding) — document reason thoroughly
-GP	Physical Therapy Plan of Care	Required when 97597 is rendered by or under a physical therapist plan of care in an outpatient setting
-GO	Occupational Therapy Plan of Care	Required when 97597 is rendered under an OT plan of care
-GN	Speech-Language Pathology Plan of Care	NOT applicable to 97597
-51	Multiple Procedures	When 97597 is performed alongside other surgical procedures at the same session; apply to the lower-valued code
-58	Staged or Related Procedure	When serial debridement sessions are planned and documented as staged treatment within a broader wound care plan

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🩺 Common ICD-10-CM Pairings

Diabetic Ulcer (Sequence DM code first per ICD-10-CM combination code rules)

ICD-10 Code	Description	HCC?	Clinical Notes
E11.621	Type 2 diabetes mellitus with foot ulcer	✅ HCC 38	Sequence FIRST per ICD-10-CM; pair with L97.4xx-L97.5xx code for site specificity; do not use if E10.x (Type 1 DM) — use E10.621 instead
E10.621	Type 1 diabetes mellitus with foot ulcer	✅ HCC 37	Sequence FIRST; pair with L97 code; distinguish T1DM from T2DM — query provider if type not documented
E11.622	Type 2 diabetes mellitus with other skin ulcer	✅ HCC 38	Use when wound is on lower leg, not foot; pair with L97.8xx or L98.49x for site specificity
L97.511	Non-pressure chronic ulcer of other part of right foot, limited to breakdown of skin	❌ No	Code as additional after E11.621 when site is right foot, severity is skin breakdown only (epidermis/dermis = appropriate for 97597 depth)
L97.521	Non-pressure chronic ulcer of other part of left foot, limited to breakdown of skin	❌ No	Code as additional after E11.621 when site is left foot, skin breakdown only

Venous Stasis Ulcer

ICD-10 Code	Description	HCC?	Clinical Notes
I87.311	Chronic venous hypertension (idiopathic) with ulcer of right lower extremity	❌ No	Sequence FIRST for venous stasis ulcer — this is a combination code capturing both the venous insufficiency and ulcer; add L97 for site and severity
I87.312	Chronic venous hypertension (idiopathic) with ulcer of left lower extremity	❌ No	Left lower extremity venous ulcer — sequence first; add L97 code
I87.313	Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity	❌ No	Bilateral venous ulcers; add L97 codes for each site debrided if bilateral debridement performed

Pressure Ulcer / Pressure Injury

ICD-10 Code	Description	HCC?	Clinical Notes
L89.511	Pressure ulcer of right ankle, stage 1	❌ No	Only epidermis involved — appropriate for 97597 depth; document stage explicitly in the note
L89.512	Pressure ulcer of right ankle, stage 2	❌ No	Partial thickness skin loss into dermis — appropriate for 97597; must document stage 2
L89.610	Pressure ulcer of right heel, unstageable	✅ HCC 161	Unstageable = eschar-covered wound; depth unknown; debridement of eschar is appropriate with 97597 if only epidermal/dermal tissue removed
L89.620	Pressure ulcer of left heel, unstageable	✅ HCC 161	Same rules as right heel

Post-Surgical / Traumatic Wound

ICD-10 Code	Description	HCC?	Clinical Notes
T81.31XA	Disruption of external operation (surgical) wound, NEC, initial encounter	❌ No	Use for wound dehiscence on initial encounter; append 7th character A for active treatment, D for subsequent
T81.31XD	Disruption of external operation (surgical) wound, NEC, subsequent encounter	❌ No	Serial debridements of dehisced surgical wound after initial encounter; 7th character D

Coding Specificity Reminder

The most commonly missed axis in wound care ICD-10-CM coding is laterality + wound severity/depth. The L97 and L89 code families require both a side (right/left/bilateral) AND a severity character (stage 1-4, unstageable, deep tissue injury). An L97 or L89 code that ends in “0” (unspecified severity) is a last-resort code — query the provider for wound stage/depth before defaulting to unspecified. For diabetic ulcers, the combination code rule is not optional: E11.621 always sequences before the L97 code. ICD-10-CM specificity requirements are not optional — a complete wound description in the note is the only thing standing between a compliant claim and a CDI query.

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🏥 MS-DRG Considerations (Inpatient)

Inpatient Coding Reminder

CPT 97597 is performed primarily in the outpatient/office/wound care clinic setting. There are no routine MS-DRG assignments driven by this CPT code — inpatient admission solely for selective skin debridement would not typically be supported by payers or utilization review bodies. If a patient undergoing an inpatient admission for an unrelated diagnosis also receives wound debridement, the facility will assign an ICD-10-PCS code (not a CPT code) for the debridement procedure. The PCS procedure may contribute to DRG assignment in MDC 09 (Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast) when the wound is the principal diagnosis. See the ICD-10-PCS section below.

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🔧 ICD-10-PCS Equivalents (Inpatient Facility Coding)

Note

Inpatient PCS coding for skin debridement is uncommon as a primary driver of admission but occurs when a wound is addressed during an inpatient stay. In PCS, the root operation is determined by the clinical intent: Excision (B) when nonviable tissue is cut out/off with the intent of removing only devitalized tissue (analogous to selective debridement), or Destruction (5) for tissue eradication. Because no device is left and no qualifier applies in most wound debridement scenarios, characters 6 and 7 will be Z/Z. Each wound site requires a separate PCS code line — PCS has no bilateral modifier equivalent.

PCS Code	Full Description	Applicable Scenario
0HBMXZZ	Excision, Skin, Right Foot, External Approach, No Device, No Qualifier	Selective sharp debridement of right foot wound — inpatient
0HBNXZZ	Excision, Skin, Left Foot, External Approach, No Device, No Qualifier	Selective sharp debridement of left foot wound — inpatient
0HB7XZZ	Excision, Skin, Right Lower Leg, External Approach, No Device, No Qualifier	Right lower leg wound debridement — inpatient
0HB8XZZ	Excision, Skin, Left Lower Leg, External Approach, No Device, No Qualifier	Left lower leg wound debridement — inpatient
0HB9XZZ	Excision, Skin, Right Ankle Region, External Approach, No Device, No Qualifier	Right ankle wound debridement — inpatient
0HBBXZZ	Excision, Skin, Left Ankle Region, External Approach, No Device, No Qualifier	Left ankle wound debridement — inpatient

PCS Character Analysis — 0HBMXZZ

Position	Character	Value	Definition
1	Section	0	Medical and Surgical
2	Body System	H	Skin and Breast
3	Root Operation	B	Excision (cutting out or off, without replacement, a portion of a body part)
4	Body Part	M	Skin, Right Foot
5	Approach	X	External
6	Device	Z	No Device
7	Qualifier	Z	No Qualifier

PCS Root Operation: Excision (B) vs. Destruction (5)

• Use Excision (B) when the clinical documentation describes selective removal of nonviable tissue — cutting away fibrin, slough, necrotic epidermis/dermis — which maps directly to the selective debridement concept of 97597
• Use Destruction (5) when documentation describes physical eradication of a body part by energy or destructive agent (e.g., laser ablation, electrocautery of a wound lesion) — less common in standard wound debridement
• When multiple wounds are debrided, assign a separate PCS code for each distinct body part — there is no PCS equivalent of a “per session” bundling concept

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📝 Coding Examples

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Example 1 — Office: Diabetic Foot Ulcer, Right Foot, Single Session

Clinical Scenario: A 67-year-old male with Type 2 diabetes mellitus, peripheral neuropathy, and a known non-healing right plantar foot ulcer presents for wound care. The wound measures 15 sq cm with slough and fibrin coating the wound bed and no granulation tissue visible. The provider performs sharp selective debridement using scalpel and forceps, removing fibrin and necrotic dermis down to viable bleeding tissue. The procedure note documents: “Selective sharp debridement of right plantar foot ulcer, 15 sq cm, with removal of fibrin, slough, and devitalized dermis; wound bed bleeding tissue visible post-debridement. Wound care instructions provided.” No separate E/M was documented beyond the wound encounter.

Field	Code	Rationale
CPT	97597	Selective debridement, open wound, first 20 sq cm (15 sq cm documented); sharp technique; single session
PDx	E11.621	Type 2 DM with foot ulcer — sequences FIRST per ICD-10-CM combination code rule
SDx	L97.511	Non-pressure chronic ulcer of other part of right foot, limited to breakdown of skin — adds site and severity specificity

Note

No modifier -25 is appropriate here because no separately identifiable E/M beyond the wound assessment was documented. The pre-procedure wound evaluation is bundled into the 97597 payment. If the provider also addressed a new complaint (e.g., chest pain, medication change) beyond the wound, -25 on the E/M code would be warranted with a separate note section.

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Example 2 — Office: Multiple Wound Sites, Same Session with Bilateral Debridement

Clinical Scenario: A 74-year-old female with chronic venous insufficiency presents for weekly wound care. She has two lower-extremity venous stasis ulcers: right medial ankle, 18 sq cm (fibrin-coated, necrotic edges), and left medial ankle, 12 sq cm (slough present). The wound care nurse practitioner performs sharp debridement of both wounds. The procedure note documents each wound’s location, size, tissue type removed, and technique. Total combined wound area = 30 sq cm. A separate problem-focused evaluation for a new complaint of right calf pain was also conducted, supported by a separate SOAP note section.

Field	Code	Rationale
CPT 1	99213-25	E/M, office outpatient established; modifier -25 on E/M, not on 97597; documents separate problem (calf pain) evaluated beyond wound assessment
CPT 2	97597	Base unit; first 20 sq cm of debridement — covers the majority of the right ankle wound
CPT 3	97597-59	Second distinct wound site (left ankle) — modifier -59 documents separate anatomic structure; alternatively use -XS
PDx	I87.311	Chronic venous hypertension with ulcer, right lower extremity — primary reason for wound care
SDx	I87.312	Chronic venous hypertension with ulcer, left lower extremity — second wound site

Warning

Modifier -25 belongs on the E/M code, not on 97597. A common audit finding is -25 appended to the procedure code, which is incorrect and will be flagged. The documentation must show that the calf pain evaluation was a genuinely separate service with its own assessment and plan — a single combined note without a distinct SOAP section for the separate problem will not survive audit.

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Example 3 — Outpatient Hospital: Post-Surgical Wound Dehiscence, Serial Debridement

Clinical Scenario: A 58-year-old male underwent right total knee arthroplasty six weeks ago. He presents to the outpatient wound clinic for the third serial debridement session of a dehisced surgical incision at the anterior knee. The wound measures 8 sq cm. Per the procedure note: “Serial session 3: sharp selective debridement of dehisced right knee surgical wound, 8 sq cm, fibrin and devitalized dermis removed; wound bed viable post-treatment. Patient instructed on daily dressing changes.” Prior sessions were billed on separate dates without issue.

Field	Code	Rationale
CPT 1	97597-58	Selective debridement, 8 sq cm; modifier -58 documents staged/planned procedure within the global period of the original TKA (90-day surgical global)
PDx	T81.31XD	Disruption of external surgical wound, NEC, subsequent encounter — 7th character D for serial/subsequent treatment visits after initial presentation

Note

Global period reminder: The original TKA (CPT 27447) carries a 90-day global period. 97597 is a separate procedure with its own 000-day global, but it is being performed during the 90-day global window of a previous surgery. Modifier -58 establishes that this debridement was planned, staged, or related to the original operative procedure, allowing separate billing. Without -58, the claim will be denied as falling within the global period of 27447. Ensure the referring/operating surgeon and wound care provider coordinate documentation to demonstrate medical necessity for the serial wound care episodes.

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⚠️ Common Coding Pitfalls

• Coding 97597 when debridement extends into subcutaneous fat or deeper: The most critical selection error in wound debridement coding. If the procedure note states “debridement down to subcutaneous fat,” “subcutaneous tissue debrided,” or “fatty tissue visible in wound bed,” 97597 is wrong and 11042 applies. Code selection is driven by the deepest tissue layer removed — if the documentation is ambiguous about depth, a CDI query to the provider is appropriate before coding. Downcoding 97597 to 11042 also changes the global period from 000 to 010.

• Reporting multiple units of 97597 instead of stacking 97597 + 97598: 97597 is a “per session” code for the first 20 sq cm; it is never reported in multiples of itself. When a single session involves a wound or combined wounds exceeding 20 sq cm, report 97597 once and add-on 97598 for each additional 20 sq cm (or part thereof). Billing two units of 97597 for a 35 sq cm wound is incorrect and will be denied or recouped under NCCI edits.

• Appending modifier -25 to 97597 instead of the E/M code: Modifier -25 is an E/M modifier — it belongs on the evaluation and management code, not on the procedure code. Appending -25 to 97597 has no coding meaning, will confuse payers, and may result in both claims being denied. The procedure note must document two distinct services (wound care + separate evaluation of an unrelated problem) to support -25 at all.

• Failing to document wound surface area in square centimeters: The 97597/97598 family is inherently surface-area-dependent. Without a documented measurement, the claim has no basis for the specific code selected and will not survive audit. Wound measurements in non-metric units or vague descriptors (“quarter-sized,” “large”) are not sufficient. The note must state the wound area in sq cm; if multiple wounds were debrided, each must be documented individually.

• Using unspecified ICD-10-CM wound codes without querying: L97.509 (non-pressure chronic ulcer, unspecified) and L89.90 (pressure ulcer, unspecified) are last-resort codes. The L97 and L89 families require laterality AND severity stage — both are usually available in the wound care note. Defaulting to unspecified codes without querying the provider creates HCC capture gaps, risks medical necessity denials from payers requiring specificity, and does not accurately reflect the clinical picture. Query first; unspecified codes are a last resort.

• Billing 97597 and 97602 for the same wound site same session: 97597 (selective debridement) and 97602 (non-selective debridement) are mutually exclusive at the same wound same session under NCCI edits. If both selective and non-selective techniques were used in one session, 97597 (the higher-value selective code) prevails. Only one debridement method code per wound per session is appropriate; the procedure note must describe which technique was used to justify the code selected.

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📎 Sources

¹ AMA CPT 2026 Professional Edition — Code 97597, Active Wound Care Management · ² CMS CY 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F), published November 2025 · ³ CMS RVU26A Relative Value Files — wRVU 1.29 for 97597 · ⁴ NCCI Policy Manual, Chapter 11 (Medicine), CMS 2025-2026 · ⁵ ICD-10-CM Official Guidelines for Coding and Reporting FY2026 — Section I.C.4 (Diabetes), Section I.C.12 (Skin and Subcutaneous Tissue) · ⁶ ICD-10-PCS Official Guidelines for Coding and Reporting FY2026 — Root Operation Excision (B) vs. Destruction (5), Section B3 · ⁷ CMS Billing and Coding: Wound Care and Debridement (Article A55818) · ⁸ CMS LCD L34587 — Billing and Coding Guidelines for Wound Care, Palmetto GBA · ⁹ AAPC — CPT Code 97597, Active Wound Care Management Code Reference · ¹⁰ Elite Med Financials — Wound Care Billing Guidelines 2026 (published February 2026)