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 […]

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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 […]

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 […]

Proof of Delivery Forms

Proof of Delivery: Part 2

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. It may be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or Comprehensive Error Rate Testing (CERT) medical review contractors. In last […]

Proof of Delivery Forms

Proof of Delivery: Part 1

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 proof may be needed to substantiate payment. It may be requested by DMEMACs, recovery auditors, supplemental medical review contractors, or Comprehensive Error […]

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 […]

Special Notice: Recent Clarification Announced by CMS

Clarification in Order Requirements for DME Dispensing In a MLN Matters article dated October 12, 2018, CMS announced a clarification in order requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). Effective November 13, 2018, “when the prescribing practitioner is also the supplier, and is permitted to furnish specific items of DMEPOS, a separate […]