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The Best Method For Measuring a Wound

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.

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Updates to Surgical Dressing Documentation Requirements

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 […]

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How Much Are You Getting Paid For That? Part II

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 […]

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6 Ways to Practice Smarter

In my previous blog, I discussed knowing your numbers to maintain a robust bottom line. Here are other practice management tips that can dramatically increase your bottom line. You must see patients. I am all for vacations and time off to recharge, but I find that some doctors take too many days off or reduce […]

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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 […]

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 […]

Face-To-Face Exam

The Face-To-Face Examination Requirement

Among the requirements that must be satisfied when dispensing surgical dressings and compression garments is a face-to-face (FTF) examination.  This FTF exam must take place within six months of the time the order is written for the surgical dressing(s) or compression garment.  It is acceptable if the FTF exam takes place on the same day […]

A- Modifier

Billing For Surgical Dressings: A- Modifiers

One of the most important steps to ensure clean billing of surgical dressings is the appropriate use of the A- modifier.  The A- modifier must be used to indicate two things: Is the dressing billed for a primary or secondary dressing? How many wounds are being treated with the dispensed dressing?  An important differentiation is […]