But how does one determine billing for wound care services? How do we verify what we are told, and how do we locate the changes? I believe we can make sense of Wound Care Billing utilizing the information from Centers for Medicare and Medicaid Services (CMS). The enclosed will show how to easily utilize the CMS web site as a resource for finding this information.

Do any of these statements sound familiar? Mark all the supplies used on the bill. Medicare considers the dressing part of the procedure so you cannot bill Medicare for the supplies. Mark your bill showing everything that is done. You cannot bill those two procedures together – one is considered part of the other. The coding department will add the modifiers so that you can bill every thing.

We hear the reimbursement for this is “X” amount of dollars- without realizing that it may not be reimbursed because it is part of the procedure cost. Understanding what is packaged together, and what our reimbursement rate is will help us make better decisions.

Opinions differ with regard to sharing the reimbursement rates with the clinic staff or not. One argument against this is, not wanting to influence clinical decision. The opposing argument goes to having a successful clinic is to understand reimbursement rates and supply cost.

The cost of business to care for these patients is placing stress on how to provide quality care. By applying the resources listed in this article the questions posed will be linked to the appropriate reference; providing concrete answers and eliminating the confusion found in many clinics.