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
Inappropriate Payment Denials
What Is Happening There have been multiple recent incidences of surgical dressing payment denial based on an auditor's finding that four weeks of conservative treatment was needed prior to dispensing surgical dressings. Why Read More →
How To Respond To Medicare DME A6010 Audit Request
So, you have received a Medicare DME A6010 Audit. First, don't worry. If they are requesting one chart at a time, this is not a full-blown audit. These are post-payment audits. Medicare goes through Read More →
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. The Rules Some non-Medicare third-party payers Read More →
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 Read More →
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 Read More →
