When dispensing surgical dressings and submitting a claim for payment, it is important to adhere to compliance guidelines. When dispensing surgical dressings to Medicare beneficiaries, these guidelines are clearly listed in the Durable Medical Equipment Medicare Administrative Contractor (DMEMAC), Surgical Dressings Local Coverage Determination (L33831), and Local Coverage Article (A54563). The above-referenced policies inform providers […]
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 […]
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 […]
A Medicare beneficiary may choose to receive hospice care after a doctor certifies that they are terminally ill, meaning they have a life expectancy of 6 months or less. Patients who choose hospice care agree to comfort care (palliative care) instead of care to cure their illness. These patients sign a statement indicating that they […]
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 […]
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.
Dispensing surgical dressings in your office improves outcomes, improves 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 so many to choose from, it can be difficult to select the best option. In last month’s blog, we looked at Foam […]
Dispensing surgical dressings in your office improves outcomes, improves 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 so many to choose from, it can be difficult to select the best option. In the first of this […]
AMERX Health Care provides extensive and detailed guidance to the AMERX Network of Physicians. This guidance covers compliance when dispensing surgical dressings and includes documentation requirements. Many providers are comfortable with the documentation that is required when initially dispensing surgical dressings. However, it is just as important to be comfortable with the regulations regarding the […]
When providing Durable Medical Equipment (DME) to Medicare Part B beneficiaries, there are certain situations where an Advanced Beneficiary Notice (ABN) may be required. An ABN should be issued to the patient before they receive DME that is usually covered by insurance but is not in this particular case. Issuing the ABN prior to delivery […]