Choosing the Right Dressings: When to Select Foam

Dispensing surgical dressings in your office improves outcomes, improves patient satisfaction, and can result in tremendous profits.  The main surgical dressings that can be dispensed include:

With so many to choose from, it can be difficult to select the best option.  In the first of this blog series intended to help with that selection, we investigate foam dressings.

Drainage Matters

AMERX® Foam Dressing is highly absorbent, which helps us with heavily draining wounds.  Excessive drainage can contribute to maceration, infection, and other complications.  Foam dressings can help prevent these complications and maintain a healthy wound environment even in the face of heavy drainage.  Venous leg ulcers often present with the volume of drainage that necessitates a foam dressing.  Foam dressings are also particularly useful in situations where a dressing may need to be left in place for multiple days, as foam can handle multiple days’ worth of drainage.  This may occur following a procedure or when the patient relies on assistance for dressing changes and availability of that assistance is limited.

Combining with Other Dressings

Foam dressings can serve as either a primary dressing or a secondary dressing.  Foam serves as a primary dressing when it is applied directly to the wound bed.  It can serve as a secondary dressing when it covers and secures a primary dressing in place.  For example, collagen powder as the primary dressing and foam as the secondary dressing are often dispensed together for wounds with moderate drainage.  The requirements for the wound to have moderate to heavy drainage and to be Stage III or IV apply to foam as both a primary dressing and a secondary dressing.

Documentation Requirements

Beyond establishing medical necessity, the documentation must also illustrate that the wound being treated has “moderate to heavy” drainage and is a Stage III or Stage IV wound.

Foam is NOT covered if:

  • the note does not indicate the Staging of the wound
  • if the documentation indicates a Stage I or II wound is being treated.

Even after payment is made, recoupments can occur if inadequate or inconsistent documentation is discovered later.

In Conclusion

Foam is highly absorbent , can serve as a primary or secondary dressing, and appropriate for Stage III and Stage IV wounds with moderate to heavy drainage.

DISCLAIMER: The information provided here is intended to educate health care providers regarding compliance for ICD, CPT, and HCPCS coding. The information provided does not guarantee reimbursement and is accurate to the best of our knowledge at the time of this publication. Coding guidelines can change and we encourage you to stay up to date. The existence of a code does not guarantee payment.

About the Author

Dr. Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC

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.

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