Dr. Lehrman is in private practice in Fort Collins, CO and operates Lehrman Consulting, LLC. He is a Diplomate of the American Board of Foot and Ankle Surgery, Fellow of the American Society of Podiatric Surgeons, and is recognized as a “Master” by the American Professional Wound Care Association. He is a Fellow of the American Academy of Podiatric Practice Management and an Expert Panelist on Codingline. In his role as a Consultant to the APMA Health Policy and Practice Department, Dr. Lehrman serves as an advisor to the APMA Coding Committee and the APMA MACRA Task Force. Dr. Lehrman sits on the board of directors of both the American Professional Wound Care Association and the American Society of Podiatric Surgeons. He is also on the editorial advisory board of the journal WOUNDS.
Can we dispense surgical dressings to patients who have medical insurance that is not Medicare Part B? Yes! Many non-Medicare third-party payers provide coverage for surgical dressings. Some non-Medicare third-party payers that provide coverage for surgical dressings for their beneficiaries have their own surgical dressing policy. Similar to the Durable Medical Equipment Medicare Administrative Contractor […]
Providers often ask whether they are permitted to “waive” payments that are patient responsibility. Legal interpretation of Medicare guidelines usually results in the guidance that providers have to make a “reasonable attempt” or “bona fide attempt” to collect any payments that are the responsibility of the patient. This answer can differ based on the third-party […]
When dispensing surgical dressings and submitting a claim for payment, it is important to adhere to compliance guidelines. When dispensing surgical dressings to Medicare beneficiaries, these guidelines are clearly listed in the Durable Medical Equipment Medicare Administrative Contractor (DMEMAC), Surgical Dressings Local Coverage Determination (L33831), and Local Coverage Article (A54563). The above-referenced policies inform providers […]
Documenting an adequate description of an ulcer being treated is essential when dispensing surgical dressings. Providers know the elements that are necessary to thoroughly document a wound. These elements are taught in school. However, this list of elements may not satisfy the requirements of a third-party payer. From a payment perspective, the required elements of […]
According to the Durable Medical Equipment Medicare Administrative Contractors (DMEMACs), the definitions of primary and secondary surgical dressings are: Primary Dressing – Therapeutic or protective covering applied directly to wounds or lesions either on the skin or caused by an opening to the skin. Secondary Dressing – Materials that serve a therapeutic or protective function […]
A Medicare beneficiary may choose to receive hospice care after a doctor certifies that they are terminally ill, meaning they have a life expectancy of 6 months or less. Patients who choose hospice care agree to comfort care (palliative care) instead of care to cure their illness. These patients sign a statement indicating that they […]
Accurate diagnosis coding is essential when providing wound care. This can include primary, secondary, and sometimes even tertiary diagnoses. When a comorbid condition contributes to the care of a wound care patient, it may be appropriate to list the ICD-10 code representing that comorbid condition on the claim form. There are major changes this year […]
Dispensing surgical dressings in your office can improve outcomes, patient satisfaction, and can result in tremendous profits. The main surgical dressings that can be dispensed include: Collagen Foam Calcium Alginate Hydrogel Gauze Hydrocolloid Compression Garments With many options, it can be difficult to select the best option. In last week’s blog, we looked closely at AMERIGEL® […]
Dispensing surgical dressings in your office can improve outcomes, patient satisfaction, and can result in tremendous profits. The main surgical dressings that can be dispensed include: Collagen Foam Calcium Alginate Hydrogel Gauze Hydrocolloid Compression Garments With many options, it can be difficult to select the best option. In last month’s blog, we looked closely at […]
Last week, the Durable Medical Equipment Medicare Administrative Contractors (DMEMACs) made a change to their joint Surgical Dressing Local Coverage Article (LCA) that states calcium alginate can serve as either a primary dressing or a secondary dressing. Prior to this change calcium alginate could only serve as a primary dressing. This change is effective now.