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

AMERIGEL® Hydrogel Wound Dressing 3 oz. and 1 oz. tubes shown

Choosing The Right Dressings: When to Select Hydrogel

Dispensing surgical dressings in your office can improve outcomes, patient satisfaction, and can result in tremendous profits.  The main surgical dressings that can be dispensed include: Collagen Foam Calcium Alginate Hydrogel Gauze Hydrocolloid Compression Garments With many options, it can be difficult to select the best option.  In last month’s blog, we looked closely at […]

Closeup of CMS Form 1500 with Box 17 Highlighted

CMS Form 1500: Is Box 17 Correct on YOUR Forms?

One of the most common errors I see when auditing wound care and DME billing is found in box 17 on the CMS 1500 form.  This is the box that lists the referring, supervising or prescribing physician. Many electronic health record (EHR) programs automatically fill in this information with the referring physician (aka the primary […]

Special Notification about Calcium Alginate

SPECIAL NOTICE: Calcium Alginate – Now a Primary OR Secondary Dressing

Last week, the Durable Medical Equipment Medicare Administrative Contractors (DMEMACs) made a change to their joint Surgical Dressing Local Coverage Article (LCA) that states calcium alginate can serve as either a primary dressing or a secondary dressing.  Prior to this change calcium alginate could only serve as a primary dressing. This change is effective now.

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