Insurance Coverage Form

Surgical Dressings For Non-Medicare Patients

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 […]

Nurse staff collecting payment from customer

Copay Collection Requirement

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 […]

Documenting Exudate

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 […]

Doctor Filling Paperwork

Adequate Wound Documentation

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 […]

AMERX Group Dressings

Documenting Primary Versus Secondary Surgical Dressings

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 […]

Elderly patient with surgical dressings

Surgical Dressings for Hospice Patients

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 […]

ICD-10 Code Changes for the New Year

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 […]

Product images of AMERX Hydrocolloid Dressings

Choosing The Right Dressings: When to Select Hydrocolloid

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® […]

AMERIGEL® Hydrogel Wound Dressing 3 oz. and 1 oz. tubes shown

Choosing The Right Dressings: When to Select Hydrogel

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 […]

Special Notification about Calcium Alginate

SPECIAL NOTICE: Calcium Alginate – Now a Primary OR Secondary Dressing

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.