The Latest in Reimbursement & Coding Information from the Blog
Special Notice: Recent Change Announced by CMS
Change in Order Requirements for DME Dispensing In a MLN Matters article dated October 12, 2018, CMS announced a change in order requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). Effective November 13, 2018, “when the prescribing practitioner is also the supplier, and is permitted to furnish specific items of DMEPOS, a separate […]
Billing For Surgical Dressings: A- Modifiers
One of the most important steps to ensure clean billing of surgical dressings is the appropriate use of the A- modifier. The A- modifier must be used to indicate two things: Is the dressing billed for a primary or secondary dressing? How many wounds are being treated with the dispensed dressing? An important differentiation is […]
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 […]
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 […]
Is Your Diagnosis Code Appropriate for the Dispensed Dressing?
Some surgical dressings only have coverage for full thickness ulcers. These include alginates, foams, and hydrogels. When dispensing a dressing that is only covered for full thickness ulcers, it is important to not only document the presence of a full thickness ulcer, but also submit a diagnosis code that reflects the presence of a full […]