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 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

Ulcer Measurement Image SQ

The Best Method For Measuring a Wound

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When dispensing surgical dressings, it is important that the dressing size is selected appropriately based on the size of the ulcer being treated.  The dressing should be large enough to cover the entire ulcer.  However, you cannot expect reimbursement for a dressing when a smaller size is available that could have covered the same ulcer.

Dec.-Lehrman-Blog-Image SQ

Updates to Surgical Dressing Documentation Requirements

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AMERX Health Care provides you with extensive resources that include everything you need for perfect documentation to ensure compliance when dispensing surgical dressings.  The majority of this guidance comes from the DMEMAC Surgical Dressings LCD and the DMEMAC Surgical Dressing Policy Article.  On December 3, 2019, the DMEMACs released some additional guidance in the form […]

Medicare Reimbursement Calculation SQ

How Much Are You Getting Paid For That? Part II

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In last month’s post, we provided the information needed to access the current durable medical equipment (DME) and / or prosthetics (DMEPOS) fee schedule.  When opening the file for the current fee schedule, the HCPCS codes are listed from top to bottom in column A.  The reimbursement dollar value is listed for each state from […]