Office Visits, Unna Boot Application, and Wound Debridement

Question:

Could you provide guidance regarding office visits, the use of an Unna boot or Profore (application or removal), and wound debridement at the time of the visit. I am unclear if the codes for Unna boots, office visits, and debridements on the same day are mutually exclusive, need special modifiers, or flat out cannot be billed simultaneously. Thank you.

Answer:

When the purpose of the visit is to remove an existing Unna boot or Profore, perform wound debridement, and apply a new Unna boot or Profore, an E/M service should not be reported, as the evaluation and management work is inherent to the wound care procedures. An E/M service may only be reported, with modifier 25, when a separate, significant, and identifiable condition is evaluated and managed beyond the wound itself.

Medicare states that all supply items related to an Unna boot are included in CPT code 29580. When debridement and Unna boot application are performed on the same anatomic area during the same encounter, only the debridement is reimbursable; if no debridement is performed, only the Unna boot application may be reported. The NCCI Policy Manual for Medicare Services, Chapter 4, Section G, prohibits reporting debridement codes 11042–11047 or 97597 with codes 29580 or 29581 for the same anatomic area.

*This response is based on the best information available as of 01/22/26.