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
Expansion of Coverage For EXTREMIT-EASE
On November 1, CMS released the CY 2024 Final Home Health Prospective Payment System Final Rule. This Rule contains significant changes that expands coverage for lymphedema treatment, including EXTREMIT-EASE. Lymphedema Coverage Starting January 1, Read More →
New ICD-10 Clinical Modifications
A new ICD-10 Clinical Modification (ICD-10-CM) code set took effect October 1, 2023. In this new code set, there are changes that may relate to the care of wounds using surgical dressings. Below is Read More →
Limits to Skin Substitutes Continue to Grow
AMERX has previously shared multiple proposals that pose a significant threat to skin substitute services. Three Part B Medicare Administrative Contractors have proposed to limit the number of skin substitute applications within an episode Read More →
New Surgical Treatment of Nails Policy
The Centers for Medicare and Medicaid Services (CMS) has implemented a nationwide policy concerning the surgical treatment of nails. This policy establishes utilization parameters regarding the use of CPT®1 11730 and 11732*. The policy Read More →
Debridement & Compression at Same Encounter
Question: Can we submit CPT® codes1 for both applications of a below knee, multi-layer compression system and ulcer debridement when both are performed for the same ulcer at the same encounter? Answer: No Read More →
