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

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

Separately Identifiable E/M Demystified

Does dispensing surgical dressings at the same encounter as an ulcer debridement count as an evaluation and management (E/M)? Short answer: Probably not. Longer answer: It depends. It depends on what was performed, documented, and medically necessary.  You can submit an E/M at the same time as a debridement (or any procedure) if—and only if—an […]

AMERX® Wound Care Kit - Hydrogel

Coding For A Debridement? Be Sure Your Diagnosis Code Makes Sense.

The surgical dressings available from AMERX Health Care are only covered by a patient’s insurance if they are being used for a surgical wound or a debrided wound.  This debridement can be surgical, mechanical, chemical or autolytic.  When performing a surgical debridement, both the CPT code selection and ICD-10 code selection are important. CPT Coding […]

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 […]