Read Part 1 The upcoming changes CMS is proposing on CTPs in regards to the treatment of Diabetic Foot Ulcers and Venous Leg Ulcers may have an impact for wound care programs on Medicare coding, coverage, and reimbursement. However, knowing what those changes are and what it means for wound care programs is sometimes unclear. … Continued
Wound Care Advantage Introduces a Free Crash Course Series on Leading a Wound Care Program Delayed wound care can mean a limb or a life, many times both, for a patient with a non-healing wound. With the rate of patients living with a chronic wound nearing the 7 million mark in the United States, and … Continued
Read Part 2 Throughout the recent talk of the changes Centers for Medicare & Medicaid Services (CMS) have proposed in regards to Cellular Tissue-Based Products (CTP’s), concerns have been raised in the current gaps of education and documentation needs with these products across the nation. In discussions about what CMS is proposing, industry leaders break … Continued
The Medicare Administrative Contractor Palmetto recently released the results of a post payment probe for hyperbarics (HCPCS Code: G0277). We’ve seen this before within our industry and it usually means another round of audits are coming. Here’s a summary of the findings and how you can avoid hyperbaric denials through strong documentation practices:
What is happening? Medicare has instructed all MAC’s not to process payments for Medicare participants and providers until the 2% sequestration extension can be deliberated by congress. The House is expected to take up the Senate-passed bill the week of April 13 when it returns to Washington D.C. We anticipate this issue to continue until … Continued
Local Coverage Determinations (LCDs) are decisions made by a Medicare Administrative Contractor (MAC) whether to cover a particular item or service in a MAC’s region. This blog post will dig into the new proposed Noridian Wound Care LCD language. We are suggesting that, even if you’re not under the Noridian jurisdiction, you should still know … Continued
Effective January 1, 2021, new reporting guidelines will be implemented and code selection for office/outpatient E/M services will be based on new criteria.
Effective January 1, 2021, new reporting guidelines will be implemented and code selection for office/outpatient E/M services will be based on new criteria.
It’s important to know how to navigate the reimbursement landscape when using cellular and tissue-based products (CTP) for wound care patients. In this post, COO Rylan Smith offers his insights on how to make the best decisions for your patients when using skin substitutes.
Medicare and other providers have increased scrutiny of modifier 25, and the Office of the Inspector General (OIG) has identified it as a potential area of overuse or misuse, thereby increasing the possibility of audits. Here’s what you need to know.