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
Can We Code For An Unna Boot and Ulcer Debridement at the Same Encounter?
No. The reference for this is in the National Correct Coding Initiative (NCCI).1,2 The Guidance Chapter IV, Section G.2 of the NCCI Policy Manual states: "Casting/splinting/strapping CPT Codes shall not be reported for Read More →
Considerations in Dispensing Compression Therapy with EXTREMIT-EASE
Providers can dispense the EXTREMIT-EASE® Compression Garment directly to patients. Patients enjoy being given the product they need, rather than trying to fill a prescription. Furthermore, EXTREMIT-EASE is much easier for patients to apply Read More →
ICD-10-CM Changes
A new ICD-10 Clinical Modification (ICD-10-CM) code set took effect on October 1, 2021. There are some changes to codes that may relate to wound care. As a reminder, if a pathology played a Read More →
Don’t Use “Unspecified” ICD-10-CM Codes in Wound Care
Why It Is Wrong The use of an "unspecified" ICD-10-CM code normally indicates that the documentation did not contain the information that was necessary to select the appropriate specific code. Example ICD-10-CM coding Read More →
Documenting Medical Necessity
Umbrella The presence and documentation of medical necessity is an umbrella requirement that applies to all medical services and supplies when submitting for payment to a third-party payer. This applies to all evaluation and Read More →
