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.
Must be logged in to access this content
The Latest in Reimbursement & Coding Information from the Blog
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 →
Top 5 Reasons for Surgical Dressings Denial – Avoid Them!
One DMEMAC (CGS) recently released its quarterly report containing the top reasons for denials of surgical dressing claims1. Here, the top 5 reasons in that list are shared along with guidance regarding how to Read More →
Increases to 2023 DME Fee Schedule!
The 2023 CMS DME Fee Schedule can be found here: https://www.cms.gov/medicaremedicare-fee-service-paymentdmeposfeescheddmepos-fee-schedule/dme23 This fee schedule is typically updated quarterly. Updates usually result in links for four different fee schedules for each previous calendar year and Read More →
