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    v1.0.28
    OpenPayerBilling CodesTemporary National Codes (Non-Medicare)HCPCS hcpcs-s9097-home-visit-wound-care
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    HCPCS Level II S9097: Home Visit for Wound Care

    HCPCS Level II code S9097 represents a home visit for wound care, a skilled clinical service provided in the patient’s residence for assessment, dressing changes, and related wound management procedures; the service type is wound care visit and the typical site of service is home (patient residence).

    For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for New Mexico Only).

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    Table of contents

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    • Billing CodesCPT, HCPCS, DRG & more
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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an older adult with one or more chronic or acute wounds (for example, a diabetic foot ulcer, venous stasis ulcer, or pressure injury) who is homebound due to limited mobility, recent hospitalization, or comorbid conditions. A licensed clinician (home health registered nurse or wound care clinician) schedules an on-site home visit to perform wound assessment, dressing change, debridement if within scope, wound culture collection if indicated, pain management, and patient/caregiver education on wound care and infection prevention. The clinician documents wound size, depth, exudate, odor, surrounding skin condition, photos as allowed, treatments applied, supplies used, and the plan of care. The visit may be part of an ongoing home health plan or a discrete home visit billed under S9097 for wound care when services occur outside a certified home health episode or when billed to payors that accept the HCPCS Level II code. Coordination with the primary care provider or wound specialist occurs when escalation, additional diagnostics, or referral is required.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11042Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or lessOften performed during wound care visits when sharp debridement of necrotic tissue is within clinician scope and payer allows billing; may be performed before dressing application.
    11043Debridement, muscle and/or fascia (includes epidermis and dermis, if performed); first 20 sq cm or lessUsed when deeper mechanical or surgical debridement is required as part of wound management during or coordinated with home visit.
    97597Debridement (non-selective) by any method, first 20 sq cm or less; selective or non-selective debridement only when performed by a qualified providerBilled when debridement is provided and payer policy allows home-based billing for this CPT alongside or instead of HCPCS code.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesMay be used when an E/M level is required for medical decision-making related to the wound and if payer accepts E/M for home visits in place of or in addition to S9097.
    29581Application of multi-layer compression system, unilateral (for venous insufficiency ulcers)Frequently provided during wound care visits for venous stasis ulcers; supplies and application may be billed under applicable CPT/HCPCS codes per payer policy.
    87070Culture, bacterial, any source, aerobic, with isolation and presumptive identification of isolatesUsed when wound culture is obtained during the visit to evaluate for infection and guide antibiotic therapy.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    282N00000XGeneral Acute Care HospitalAn acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medica…
    367H00000XAnesthesiologist AssistantAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
    372500000XChore ProviderAn individual who provides home maintenance services required to sustain a safe, sanitary living environment for individuals who because of age or dis…
    225XE1200XErgonomics Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers · Occupational Therapist
    226000000XRecreational Therapist AssistantRecreational Therapist Assistants work in support of or assistant to Recreational Therapists treating patients with disabilities, injuries, and illnes…
    207ZC0008XClinical Informatics (Pathology) PhysicianPhysicians who practice Clinical Informatics collaborate with other health care and information technology professionals to analyze, design, implement…

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    A41.9Sepsis, unspecified organism
    B95.61Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere
    E10.621Type 1 diabetes mellitus with foot ulcer
    E11.621Type 2 diabetes mellitus with foot ulcer
    E11.65Type 2 diabetes mellitus with hyperglycemia
    G62.0Drug-induced polyneuropathy
    I50.33Acute on chronic diastolic (congestive) heart failure
    I83.013Varicose veins of right lower extremity with ulcer of ankle
    I83.219Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation
    K86.89Other specified diseases of pancreas

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Emergency & Medical Transportation1 / 3

    10 rows

    PolicyPayerEffective Date
    Fixed Wing Air Ambulance TransportCigna2026-08-15
    Air AmbulanceAmbetter Georgia2026-08-01
    Ambulance Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Ambulance Services (for Tennessee Only)UnitedHealthcare2026-08-01
    Clinical Policy: Air AmbulanceArizona Complete Health2026-08-01
    Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceAmbetter Nevada2026-08-01
    Ambulance TransportProvidence Health Plan2026-07-01
    Air ambulance transport coverage criteriaeocco2026-07-01

    Related Codes

    HCPCS-LEVEL-II-S2152-SOLID-ORGAN-TRANSPLANTATION-GLOBAL-CARE

    HCPCS Level II S2152: Solid Organ Procurement and Transplantation

    HCPCS-LEVEL-II-S2266-INDUCED-ABORTION-29-TO-31-WEEKS

    HCPCS Level II S2266: Induced Abortion, 29 to 31 Weeks

    HCPCS-LEVEL-II-S3630-EOSINOPHIL-COUNT-BLOOD-DIRECT

    HCPCS Level II S3630: Eosinophil Count, Blood, Direct

    HCPCS-LEVEL-II-S4017-INCOMPLETE-ART-CYCLE-CANCELLED-PRIOR-TO-STIMULATION

    HCPCS Level II S4017: Incomplete Cycle — Cancelled Prior to Stimulation

    HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

    HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction

    HCPCS-LEVEL-II-S8940-EQUESTRIAN-HIPPOTHERAPY-PER-SESSION

    HCPCS Level II S8940: Equestrian/Hippotherapy, Per Session

    HCPCS-LEVEL-II-S9024-PARANASAL-SINUS-ULTRASOUND

    HCPCS Level II S9024: Paranasal Sinus Ultrasound

    HCPCS-LEVEL-II-S9366-HOME-TPN-1-2L-PER-DAY-HOME-INFUSION

    HCPCS Level II S9366: Home Infusion TPN, 1–2 L/day

    HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

    HCPCS S9446: Patient Education, Non-Physician Provider, Group, Per Session

    HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

    HCPCS S9451: Exercise Classes, Non-Physician Provider, Per Session

    Showing 1–10 of 532

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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