Reimbursement & Coding Information

HCPCS Coding Guidance

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 Care recommends checking with PDAC for the latest updates regarding rules and regulations for dispensing DME products. PDAC – www.dmepdac.com

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.  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.


The Latest in Reimbursement & Coding Information from the Blog

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 Equipment Medicare Administrative Contractor (DMEMAC), Surgical Dressings Local Coverage Determination (L33831), and Local Coverage Article (A54563). The above-referenced policies inform providers […]

Doctor Filling Paperwork

Adequate Wound Documentation

Documenting an adequate description of an ulcer being treated is essential when dispensing surgical dressings. Providers know the elements that are necessary to thoroughly document a wound. These elements are taught in school. However, this list of elements may not satisfy the requirements of a third-party payer. From a payment perspective, the required elements of […]

AMERX Group Dressings

Documenting Primary Versus Secondary Surgical Dressings

According to the Durable Medical Equipment Medicare Administrative Contractors (DMEMACs), the definitions of primary and secondary surgical dressings are: Primary Dressing – Therapeutic or protective covering applied directly to wounds or lesions either on the skin or caused by an opening to the skin. Secondary Dressing – Materials that serve a therapeutic or protective function […]

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