When it comes to CPT® coding, wound repair is typically classified as simple, intermediate, or complex.
When documenting and coding skin changes that result from prolonged pressure, it is important to differentiate between a pressure “ulcer” and a pressure “injury.”
“Maybe it’s time to switch our telescopic lens from auditing providers to auditing MCOs and MAs. Let’s get these RAC, ZPIC, and TPE auditors focused on the stewards of our tax dollars, the prepaid entities.”
Some providers dispense surgical dressings to patients and submit coding for the dressings to third party payers in exchange for payment.
Wound care terminology & diagnosis codes haven’t changed since 1991, but wound care technology definitely has.
Dr. David Charash has just put out an article in Today’s Wound Clinic describing his experience with a TPE (Targeted Prove and Educate) audit. Check it out!
This week is the big Spring SAWC (Symposium on Advanced Wound Care) conference! Intellicure...
HBOT treatments are most commonly provided in the hospital-based outpatient department (HOPD) but are also sometimes provided in the physician’s office.
Yes, specialists who are not the admitting / primary physician may submit CPT 99304 in certain situations.
Did you notice that Acute Arterial Insufficiency is NOT on the list? The rest of us hadn’t paid attention to that either…
This CPT is often used incorrectly. Fortunately, clarity is provided in the form of a CPT Assistant article published in December, 2002.
Targeted Probe and Educate (TPE) audits were briefly suspended for COVID-19, but now they are back.
Great opportunities to advance wound care knowledge, this week in Philadelphia!
In this game, you may find out the rules only when someone gets a penalty.
Many wound care – related procedures, including some amputations and certain incision and drainage services, carry with them a 10 or 90-day postoperative global period.
CMS Releases the Final Rules of the Medicare Physician Fee Schedule and the Hospital Outpatient Payment System
CMS has released the final rules of the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Payment System (HOPPS).
Free Access to a Review Article on the Development & Treatment of Lymphatic Dysfunction in Cancer Patients
Check out this Open Access review article on the development and treatment of lymphatic dysfunction in cancer patients.
Benchmarking allows you to visualize whether you might raise a red flag with an auditor, since we know they have been auditing debridement services.
Assessing a patient’s nutritional status during the wound healing process is of tremendous importance. Here are some lists for patients.
Last week, Dr. Caroline Fife and Dr. Helen Gelly enjoyed a relaxed, unscripted conversation about...
The MACs have been auditing wound debridements. I thought it might be useful to understand the history of debridement audits.
In the world of Revenue Cycle Management, attention to detail is no laughing matter. A seemingly minor error can lead to decreased reimbursement, cash flow delays, patient dissatisfaction and complete denial of payment.
November is Diabetes Awareness Month. For those that treat diabetic foot ulcers, this is a good opportunity to ensure your diabetic foot ulcer coding is accurate.
Severe pressure injuries continue to occur at a predictable rate, particularly among critical care patients. There’s a reason.
These proposed “rules” are hundreds of pages and filled with jargon. However, the details will control how physicians get paid in 2022.
When a significant and separately identifiable E&M and a procedure are both performed, the documentation of the encounter must clearly reflect two separate services with no overlap in work between the E&M and the procedure.
Let’s take a look at the ways in which proper nutrition can be an invaluable part of the wound healing process.
It’s finally possible to have the tools you need for outpatient wound management seamlessly integrated into the hospital EHR.
Earlier this month, the US Wound Registry conducted a market research survey intended to better...
Fellow Wound Care Warriors, welcome to the Intellicure Blog! Our team at Intellicure shares a...
Proper documentation for surgical debridement is going to take a lot of engagement with your EHR vendor.