DMEPOS Surgical Dressings Policy Article - SQ

How Often Should I Perform Wound Evaluations?

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 […]

Updated-ABN-form-sq

Your ABN Forms are Expiring!

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 […]

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Understanding Debridement and Surgical Dressing Coverage

According to the DMEMAC Local Coverage Article (LCA), Surgical Dressings – Policy Article (A54563), surgical dressings are covered when a “qualifying” wound is present.  We must understand which wounds qualify.  While there are different requirements for different dressing types, all wounds must meet certain criteria before the dressing type can even be considered.  The LCA […]

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How to Effectively Dispense Compression Therapy In-Office

Dispensing compression systems from my office is extremely rewarding.  Patients enjoy being handed the product they need, rather than having to hunt for it in their community.  Specifically, patients in need of compression therapy find that not all compression garments are right for them. Oftentimes, these patients enjoy the ease of application and adjustment that […]

Medicare Reimbursement Calculation SQ

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 […]

DMEPOS-Fee-Schedule_SQ

How Much Are You Getting Paid For That? Part 1

This should not be a guessing game, nor should it be a mystery.  Knowing what your reimbursement should be for a service is an important tool in planning treatments and in checking your Explanation of Benefits (EOBs).  This is the case with evaluation and management services, procedures, and durable medical equipment, including both surgical dressings […]

Can You Dispense Surgical Dressings/Wound Care Supplies to an Inpatient?

The short answer is… No. Medicare will not make separate payments for items dispensed during any inpatient stay in acute care hospitals, long term care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, or critical access hospitals.  Medicare makes payments to these entities via different payment systems and all payments made through these systems are considered […]

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 […]

Proof of Delivery Forms

Proof of Delivery: Part 3

The Centers for Medicare and Medicaid Services (CMS) requires that DME suppliers maintain proof that any item dispensed was received by the beneficiary in the form of a Proof of Delivery document. This could be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or Comprehensive Error Rate Testing (CERT) medical review contractors.  In our […]