Medical Files

How To Respond To Medicare DME A6010 Audit Request

So, you have received a Medicare DME A6010 Audit. First, don’t worry. If they are requesting one chart at a time, this is not a full-blown audit. These are post-payment audits. Medicare goes through phases where they audit specific items for a period. It does NOT mean that you did anything wrong. Respond. Do not […]

Insurance Coverage Form

Surgical Dressings For Non-Medicare Patients

Can we dispense surgical dressings to patients who have medical insurance that is not Medicare Part B? Yes! Many non-Medicare third-party payers provide coverage for surgical dressings. Some non-Medicare third-party payers that provide coverage for surgical dressings for their beneficiaries have their own surgical dressing policy. Similar to the Durable Medical Equipment Medicare Administrative Contractor […]

Nurse staff collecting payment from customer

Copay Collection Requirement

Providers often ask whether they are permitted to “waive” payments that are patient responsibility. Legal interpretation of Medicare guidelines usually results in the guidance that providers have to make a “reasonable attempt” or “bona fide attempt” to collect any payments that are the responsibility of the patient. This answer can differ based on the third-party […]

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 […]

ICD-10 Code Changes for the New Year

Accurate diagnosis coding is essential when providing wound care. This can include primary, secondary, and sometimes even tertiary diagnoses.  When a comorbid condition contributes to the care of a wound care patient, it may be appropriate to list the ICD-10 code representing that comorbid condition on the claim form.  There are major changes this year […]

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 […]

Burkman DME License Blog Image - SQ

Facing Medicare Advancement Repayments?

Many physicians took out loans using the CMS Advance Payment Program during Covid-19.  In the coming months, this money will begin to be deducted from your reimbursements.  Originally, this was supposed to be repaid as a 100% deduction but, due to new regulations, this has been reduced to 25%. 25% is still a large amount […]

AdobeStock_Burkman Blog- SQ

Boost Revenue in the Face of Uncertainty

Many practitioners are having to grapple with financial loss as a result of COVID -19. Many clinics are starting to open fully, and cash flow is tight. Right now, you must start generating additional income from your practice. Dispensing wound care supplies is an amazing opportunity to quickly increase your cash flow while improving patient […]