Wound Debridement Documentation Guide: 97597 vs. 11042/11043

By Elina Sabilova, CPC, CFPC, CPMA — Billing Department, WCH

The one distinction that decides everything

Both code families describe debridement of an open wound. The entire billing decision comes down to one question: did the debridement remove only dead surface tissue, or did it reach live tissue underneath?

• 97597/97598 — selective debridement. You’re removing what’s already dead: slough, biofilm, devitalized epidermis/dermis, exudate, debris. The wound bed itself isn’t being cut into.
• 11042/11043 (with +11045/+11046 as add-on codes for additional area) — excisional debridement. You’re cutting into living tissue to get to a clean, bleeding margin — necrotic subcutaneous tissue, fat, and beyond.

If depth isn’t documented, the claim downcodes to 97597 — regardless of what actually happened during the procedure.