Also referred to as skin substitutes, cellular and tissue-based products (CTPs) include non-autologous human skin grafts, non-human skin substitute grafts, and biological products that form a sheet scaffolding. They're increasingly being used in the wound care clinic for the treatment of non-healing wounds including diabetic foot ulcers, pressure ulcers, and venous ulcers. In order to ensure optimal patient care and a smooth insurance reimbursement process, it's important for wound care clinicians to strive for accurate documentation when using CTPs. Christina Le, CNO and Nick Jagodzinski, Atlantic Regional Clinical Coordinator, offer five helpful tips to help you avoid claim denials.
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.
Last week, we discussed the “Site-Neutral Rule,” which would reduce Evaluation and Management charges for off-campus outpatient programs, including wound care and hyperbaric medicine centers. This week, 38 Hospitals sued Health and Human Services (HHS), challenging the rule. The lawsuit alleges that HHS Secretary Alex Azar exceeded his authority when this rule was implemented January 1, 2019.
The OIG released the results of a MAC audit report on Hyperbaric Oxygen Therapy (HBOT) services. Based on the sample charts, they estimated there were over $39 million in HBOT overpayments for the sample year alone in this jurisdiction.
Fall brings vibrant colors, homemade chili, championship baseball – and new CMS regulations for reimbursement! In reviewing upcoming changes for 2018, here are five takeaways that wound centers need to be aware of.