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.
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 […]
Some surgical dressings only have coverage for full thickness ulcers. These include alginates, foams, and hydrogels. When dispensing a dressing that is only covered for full thickness ulcers, it is important to not only document the presence of a full thickness ulcer, but also submit a diagnosis code that reflects the presence of a full […]
While some physicians may interchange the terms “ulcer” and “wound” as if they are synonyms, when it comes to ICD-10, your choice of words DOES matter! What is the Difference between a Wound and an Ulcer? In ICD-10 language, a “wound” is something traumatic. An “ulcer” refers to a break in the skin that fails […]
Can You Bill For Two Different Dressings For The Same Ulcer? The answer is… YES! When can you dispense two dressings for the same ulcer? When a primary dressing, like collagen powder, is dispensed and requires a secondary dressing for securement, you can dispense both the primary and secondary dressings for the same ulcer—and bill […]
Multiple surgical dressings can be combined to appropriately cover a wound, however there are dressing combinations that are not appropriate. Different surgical dressings have different indications and you should not combine two dressings that have different indications for the same wound. One example of something that should not be done is to use a dressing […]