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 […]

A- Modifier

Billing For Surgical Dressings: A- Modifiers

One of the most important steps to ensure clean billing of surgical dressings is the appropriate use of the A- modifier.  The A- modifier must be used to indicate two things: Is the dressing billed for a primary or secondary dressing? How many wounds are being treated with the dispensed dressing?  An important differentiation is […]

Dr. Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC

Separately Identifiable E/M Demystified

Does dispensing surgical dressings at the same encounter as an ulcer debridement count as an evaluation and management (E/M)? Short answer: Probably not. Longer answer: It depends. It depends on what was performed, documented, and medically necessary.  You can submit an E/M at the same time as a debridement (or any procedure) if—and only if—an […]

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 […]

AMERX 30-Day Wound Care Kit with HELIX3-CM®

One Ulcer, Two Dressings

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 […]

Dr. Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC

To Combine or Not to Combine

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 […]