What Are The Challenges In Wound Care Billing Services?

1
What Are The Challenges In Wound Care Billing
Services?
2
What Are The Challenges In Wound Care Billing
Services?
Every wound care provider provide excellent care
services to patients. But they face a lot of
hurdles with wound care billing collection. Many
providers do not have a proper billing process in
place, and hence they are not able to collect
significant amount of revenue. So, it is
important to understand the challenges in the
wound care billing for wound care providers to
find the solutions for the same. Wound care
providers, billing and coding processes that
require the in-house department to be constantly
in front of them. From eligibility verification,
billing, coding, account receivable for wound
care administrators is an unbelievable challenge
in numerous wound care facilities. There is a
confusion with billing and coding is that if
there is a CPT code for a procedure, the
insurance plan will have to pay it. It is not
mandatory for insurance payers. Thought you have
a code it is not mean that the coverage for the
procedure will have incorporate in it, therefore,
it becomes imperative to know the rules under
which you must operate is a must. There is one
more common reason is not using the add-on codes
properly while submitting claims. If physician
removing over 20 sq cm of tissue at a certain
depth, medical coders should use the base code
and the add-on code. For example, if removing 28
sq cm of subcutaneous tissue, he notes the coding
would be both 11042 and 11045. For debridement of
muscle or fascia, coders report 11043 for the
first 20 sq cm and 11046 for every additional 20
sq cm.
3
What Are The Challenges In Wound Care Billing
Services?
Selective debridement (CPT codes 97597-97598) is
the removal of nonviable tissue. Unlike
excisional debridement, the physician removes no
living tissue in a selective debridement. Wound
debridement, active wound care, and open fracture
debridement coding are all different, and it
requires a mere understanding for your in-house
medical coders. Most often errors in wound care
coding occur when skin grafting/replacement is
involved. Most practices may forget to provide
the add-on codes for the actual code. For an
instance, if removing a certain length of tissue
at a certain depth, the insurer would look at the
base code and the add-on code. But for another
length of subcutaneous tissue, the insurer
identifies the coding would be combination of two
codes. These kinds of errors are seen common in
wound care coding. The wound care medical
billing process includes numerous procedures and
requires complete evaluation of the medical
records of patients for the wound that should
cover wound dimensions and chronic diseases (if
patient has any) and treatment for the same, list
of procedures offered to treat the wound,
follow-ups, firs visits, photographs of the wound
and its progress, etc. Contact us today to
streamline your wound care practice revenue cycle
management. Our medical billing manager will help
you to overcome all wound care challenges.
4
(No Transcript)