Reimbursement & Coding
HCPCS Coding Guidance
Visit the PDAC website for the latest Coverage and Payment Rules, codes and general guidelines for seeking DME reimbursement through Medicare. These guidelines do not replace directions provided by CMS. AMERX Health Care recommends checking with PDAC for the latest updates regarding rules and regulations for dispensing DME products. PDAC – www.dmepdac.com
AMERX Health Care regularly reviews and releases the latest HCPCS Coding Guidance related to our products. Download your copy today!
Common Wound Care Diagnosis & Debridement Codes for AMERX Products
AMERX Health Care has compiled a handy guide of Debridement Codes and ICD-10 Codes associated with dispensing AMERX Products, available exclusively to those health care providers already a part of the AMERX Family of Dispensing Physicians. While the information in this guide is intended to assist you and your practice with coding, the existence of a code does not guarantee payment. The information is accurate to the best of our knowledge at the time of publication, but coding guidelines can change and we always encourage you to stay up to date.
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The Latest in Reimbursement & Coding Information from the Blog
The Face-To-Face Examination Requirement
Among the requirements that must be satisfied when dispensing surgical dressings and compression garments is a face-to-face (FTF) examination. This FTF exam must take place within six months of the time the order is Read More →
Billing for Compression Therapy: -AW and Laterality Modifiers
Compression is an essential component of both healing and preventing venous leg ulcers. Not only do compression garments, such as the EXTREMIT-EASE® Compression Garment, help to treat difficult lower leg ulcers, they can also Read More →
Special Notice: Recent Clarification Announced by CMS
Clarification in Order Requirements for DME Dispensing In a MLN Matters article dated October 12, 2018, CMS announced a clarification in order requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). Effective November Read More →
Billing For Surgical Dressings: A-Modifiers
One of the most important steps to ensure clean billing of surgical dressings is the appropriate use of the A- modifier. The A- modifier must be used to indicate two things: Is the dressing Read More →
Separately Identifiable E/M Demystified
Does dispensing surgical dressings at the same encounter as an ulcer debridement count as an evaluation and management (E/M)? Short answer: Probably not. Longer answer: It depends. It depends on what was performed, documented, and Read More →
