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.
As of January 1, 2020, the DMEMAC requirement for a “Detailed Written Order” when ordering surgical dressings has changed to the requirement for a “Standard Written Order”. The required elements of a Standard Written Order are almost the same as those of the Detailed Written Order. The required elements of the Standard Written Order include: […]
When dispensing surgical dressings, it is important that the dressing size is selected appropriately based on the size of the ulcer being treated. The dressing should be large enough to cover the entire ulcer. However, you cannot expect reimbursement for a dressing when a smaller size is available that could have covered the same ulcer.
AMERX Health Care provides you with extensive resources that include everything you need for perfect documentation to ensure compliance when dispensing surgical dressings. The majority of this guidance comes from the DMEMAC Surgical Dressings LCD and the DMEMAC Surgical Dressing Policy Article. On December 3, 2019, the DMEMACs released some additional guidance in the form […]
In last month’s post, we provided the information needed to access the current durable medical equipment (DME) and / or prosthetics (DMEPOS) fee schedule. When opening the file for the current fee schedule, the HCPCS codes are listed from top to bottom in column A. The reimbursement dollar value is listed for each state from […]
This should not be a guessing game, nor should it be a mystery. Knowing what your reimbursement should be for a service is an important tool in planning treatments and in checking your Explanation of Benefits (EOBs). This is the case with evaluation and management services, procedures, and durable medical equipment, including both surgical dressings […]
The Centers for Medicare and Medicaid Services (CMS) have removed social security-based claim numbers from Medicare cards and are instead using Medicare Beneficiary Identifiers (MBIs) for Medicare transactions. All Medicare beneficiaries have received their MBIs, and it is important to collect that information. Physicians must start using the MBI instead of the social security number […]
The short answer is… No. Medicare will not make separate payments for items dispensed during any inpatient stay in acute care hospitals, long term care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, or critical access hospitals. Medicare makes payments to these entities via different payment systems and all payments made through these systems are considered […]
Surgical dressings can be used for all types of qualifying ulcers. This includes arterial ulcers, venous ulcers, diabetic foot ulcers, and pressure ulcers. It is important to use the correct diagnosis codes for each of these ulcer types. Diabetic foot ulcer codes should start with L97-. Stasis ulcer codes begin with I83-. L89- codes are […]
When dispensing surgical dressings, it is important to differentiate between primary and secondary dressings and to use them in conjunction when indicated. PRIMARY DRESSINGS Primary dressings are therapeutic or protective and can be applied directly to ulcers. SECONDARY DRESSINGS Secondary dressings are needed to secure and/or aid in the function of a primary dressing. A […]
The Centers for Medicare and Medicaid Services (CMS) require that DME suppliers maintain proof that any item dispensed was received by the beneficiary in the form of a Proof of Delivery document. This document must be maintained for at least seven years. This could be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or […]