Dec.-Lehrman-Blog-Image SQ

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 […]

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 I

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 […]

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 […]

Wound vs. Ulcer – Does It Matter?

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 […]

HELIX3® Bioactive Collagen | AMERX Health Care

Updates To LCD Regarding Collagen Dressings

Noridian Issues a Clarification Notice About Updated Collagen Dressings Coverage Prior to the latest LCD changes, DME providers who dispensed collagen for patients at-home use, could only receive coverage for full-thickness wounds. Since the middle of 2017, however, the guidelines for coverage have been amended. Full-thickness wounds Wounds with light to moderate exudate Wounds that […]