Arobella Medical - Sound Touch for Wound Care™

Qoustic Wound Therapy System™ 2016 Reimbursement Information

The Qoustic Wound Therapy Systemô is indicated for producing and delivering low frequency ultrasound used to promote wound healing via:

  • Selective and non-selective dissection and fragmentation of soft and/or hard tissue
  • Surgical, excisional or sharp-edge wound debridement (acute and chronic wounds, burns) for the removal of nonviable tissue including but not limited to diseased tissue, necrotic tissue, slough and eschar, fibrin, tissue exudates, bacteria and other matter
  • Site cleansing irrigation and lavage of wound tissue (acute and chronic wounds, burns, diseased or necrotic tissue)
  • Contact and/or non-contact maintenance debridement for the removal of debris, exudates, fragments, bacteria, slough, fibrin, excised or fragmented tissue, and other matter
  • Preparing the wound bed for graft or other subsequent procedures using contact and/or non-contact techniques to achieve wound debridement

It is prescribed for patient population of any age with one or more wounds and/or that may also exhibit Diabetes Mellitus (DM)1

The reimbursement information provided by Arobella Medical, LLC. is gathered from third-party sources and is presented for illustrative purposes only. It does not guarantee coverage or reimbursement for services performed utilizing the Qoustic Wound Therapy System. Arobella has made every effort to ensure the completeness and accuracy of the information contained herein; however, no representations or warranties are made regarding the selection of codes for the use of Arobellaís products or the services in which the products may be used, or for compliance with any billing protocols or procedures, requirements, or prerequisites.

As with all coverage claims, individual physicians and facilities are responsible for exercising their independent clinical judgment in selecting the codes that most accurately reflect the patientís condition and the services provided to a patient. Healthcare providers are encouraged to contact the individual Medicare contractor, carrier, fiscal intermediary or other third-party payers, as needed.


2016 Medicare National Unadjusted Average Payment Rates2


CPT Code3 Description Physician Payment (Non-facility or office / Facility) Hospital Outpatient Payment Ambulatory Surgical Center Payment
Surgical Debridement
11000 Debridement of extensive eczematous or infected skin; up to 10% of body surface $58.35 / $31.07 $305.10 $32.22
11001+ Debridement of extensive eczematous or infected skin; each additional 10% of the body surface (List separately in addition to code for primary procedure) $23.11 / $15.53 Bundled Bundled
11042 Debridement; subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less $126.04 / $67.07 $305.10 $126.13
11045+ Debridement; subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) $43.96 / $28.42 Bundled Bundled
11043 Debridement; muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 3 sq cm or less $245.91 / $169.37 $305.10 $239.70
11046+ Debridement; muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) $79.19 / $61.00 Bundled BUndled
Active Wound Care Management
97597 Debridement (e.g., high pressure water jet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudates, 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 $80.33 / $25.01 $165.76 N/A
97598+ Debridement (e.g., high pressure water jet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudates, 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; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) $26.14 / $11.75 Bundled N/A
97602 Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session Bundled / Bundled $119.59 N/A
97610 Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day $127.69 / $17.05 $119.59 N/A
Pressure Ulcers (Decubitus Ulcers)
15999 Unlisted procedure, excision, pressure ulcer N/A / N/A $228.27 N/A
Burns, Local Treatment
16020 Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area) $87.53 / $58.73 $165.76 $55.25
16025+ Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area) $158.38 / $120.87 $165.76 $82.88
16030+ Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area) $199.68 / $145.50 $305.10 $167.24
Other Procedures
17999 Unlisted procedure, skin, mucous membrane and subcutaneous tissue N/A / N/A $119.59 N/A

1 FDA cleared labeling for the Qoustic Wound Therapy System™, K062544 & K131096.
2 Payment amounts shown for Medicare National Average 2016 Physician Fee Schedules (MPFS) and Medicare Hospital Outpatient Ambulatory Payment Classification (APC) National Average Benchmarks are not a guarantee of payment.
3 Current Procedural Terminology (CPT) is copyright 2014 of the American Medical Association (AMA). All rights reserved.

Documentation Guidelines

Providers who perform wound debridement are advised to document and maintain complete and accurate medical records for each wound care patient and procedure. The following general documentation checklist is provided for your convenience. Please note that this list is a general guideline only. Individual documentation requirements may vary. Providers are encouraged to develop their own methods of record keeping, but, at a minimum, those records should include the components outlined in the checklist.

At A Minimum, The Following Should Be Documented In The Patient Chart:

  1. Level of tissue removed
    • Skin
    • Full thickness
    • Partial thickness
    • Subcutaneous
    • Muscle
    • Bone
  2. Character of the wound
    • Before debridement
    • After debridement
  3. Medical necesity for debridement
  4. Plan of care with treatment goals
  5. Physician follow up
  6. Evidence of progres of the wound's response to treatment
    • Current wound size
    • Wound depth
    • Signs of infection
    • If present, extent of infection
    • Presence or absence of necrotic, devitalized or non-viable tissue
    • If present, extent of the diseased tissue
  7. Appropriate evaluation and management of medical conditions that may affect the course of wound healing

Note: Some payers may also require periodic evaluation of the wound (no less than every 30 days)