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Telemedicine & Surgical Dressings During the COVID-19 Pandemic

The Centers for Medicare and Medicaid Services (CMS) has announced waivers and loosened some provider restrictions since the public health emergency was declared.  There have been new announcements every day.  A concern among providers who dispense surgical dressings is the need to document, on a monthly basis, clinical information which demonstrates the reasonable and necessary […]

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Choosing the Proper Dressing Size

When dispensing surgical dressings, the dressing size should be selected based on the size of the ulcer being treated.  From a clinical standpoint, the dressing should cover the entire ulcer.  From a compliance and payment standpoint, it is not appropriate to use a large dressing size when a smaller size was available that could have […]

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The Best Method For Measuring a Wound

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.

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Updates to Surgical Dressing Documentation Requirements

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 […]

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How Much Are You Getting Paid For That? Part II

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 […]

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How Much Are You Getting Paid For That? Part 1

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 […]

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Time to Start Using Medicare Beneficiary Identifiers

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 […]

Can You Dispense Surgical Dressings/Wound Care Supplies to an Inpatient?

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 […]

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Get Ready! Additions to Pressure Ulcer Coding Coming Soon

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 […]