Reimbursement & Coding Information

HCPCS Coding Guidance – The link provided below contains 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 recommends checking with PDAC for the latest updates regarding rules and regulations for dispensing DME products. PDAC – www.dmepdac.com


The Latest in Reimbursement & Coding Information from the Blog

AMERX HCPCS Coding Guidance

Wound vs. Ulcer – Does It Matter?

While some physicians may interchange the terms “ulcer” and “wound” as if they are synonyms, when it comes to ICD-10, your choice of words DOES matter! What is the Difference between a Wound and an Ulcer? In ICD-10 language, a “wound” is something traumatic.  An “ulcer” refers to a break in the skin that fails […]

AMERX 30-Day Wound Care Kit with HELIX3-CM®

One Ulcer, Two Dressings

Can You Bill For Two Different Dressings For The Same Ulcer?  The answer is… YES! When can you dispense two dressings for the same ulcer?  When a primary dressing, like collagen powder, is dispensed and requires a secondary dressing for securement, you can dispense both the primary and secondary dressings for the same ulcer—and bill […]

Dr. Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC

To Combine or Not to Combine

Multiple surgical dressings can be combined to appropriately cover a wound, however there are dressing combinations that are not appropriate.   Different surgical dressings have different indications and you should not combine two dressings that have different indications for the same wound. One example of something that should not be done is to use a dressing […]

HELIX3® Bioactive Collagen | AMERX Health Care

Updates To LCD Regarding Collagen Dressings

Noridian Issues a Clarification Notice About Updated Collagen Dressings Coverage Prior to the latest LCD changes, DME providers who dispensed collagen for patients at-home use, could only receive coverage for full-thickness wounds. Since the middle of 2017, however, the guidelines for coverage have been amended. Collagen is now covered for three wound types: Full-thickness wounds […]