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

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Get Ready! Additions to Pressure Ulcer Coding Coming Soon

Surgical dressings can be used for all types of qualifying ulcers.  This includes arterial ulcers, venous ulcers, diabetic foot ulcers, and pressure ulcers.  It is important to use the correct diagnosis codes for each of these ulcer types.  Diabetic foot ulcer codes should start with L97-.  Stasis ulcer codes begin with I83-. L89- codes are […]

Dispensing Primary and Secondary Dressings With Different Change Frequencies

When dispensing surgical dressings, it is important to differentiate between primary and secondary dressings and to use them in conjunction when indicated. PRIMARY DRESSINGS Primary dressings are therapeutic or protective and can be applied directly to ulcers. SECONDARY DRESSINGS Secondary dressings are needed to secure and/or aid in the function of a primary dressing. A […]

Proof of Delivery Forms

Proof of Delivery: Part 4

The Centers for Medicare and Medicaid Services (CMS) require that DME suppliers maintain proof that any item dispensed was received by the beneficiary in the form of a Proof of Delivery document. This document must be maintained for at least seven years.  This could be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or […]