One Ulcer, Two Surgical Dressings: Practical Considerations For Dispensing And Reimbursement

Dispensing surgical dressings for ulcers provides patients with the items they need without delay, improves adherence and can add significant profits to your practice. Some surgical dressings commonly dispensed by podiatrists include collagen, foam, calcium alginate and hydrogel dressings.

The situation may arise when one ulcer requires two different dressings: one primary and one secondary. Primary surgical dressings are therapeutic or protective, and one applies them directly to ulcers. Secondary dressings secure a primary dressing and/or aid in the function of a primary dressing. Some surgical dressings can only serve as a primary dressing. Others can serve as either primary or secondary dressings.  

When a primary dressing, such as collagen powder dressing, requires a secondary dressing to secure the primary dressing, you can dispense both the primary and secondary dressings for the same ulcer and bill for both. This provides the patient with everything he or she needs, eliminates the need for the patient to go shopping for a secondary dressing, and adds profits for your office. 

There are some considerations to keep in mind when dispensing a primary and secondary dressing for the same ulcer at the same encounter.

When dispensing primary and secondary dressings for the same ulcer, be sure to document the medical necessity of both dressings. It is also recommended that both the primary and secondary dressings have similar change frequencies. It is also not appropriate to dispense two dressings for the same ulcer at the same time that have different indications.  

Dispensing two different surgical dressings for the same ulcer can ensure the patient has everything he or she needs to care for the ulcer and help to achieve excellent outcomes. Appropriately dispensing two dressings for the same ulcer at the same visit can also increase your per visit value and add to the profitability and success of your office’s durable medical equipment (DME) program.

Dr. Lehrman operates Lehrman Consulting, LLC, is a consultant to the APMA Health Policy and Practice Department, serves as an expert panelist on Codingline, and is a Certified Professional Coder. Follow him on Twitter @DrLehrman

Current Procedural Terminology (CPT^®) copyright 1966, 1970, 1973, 1977, 1981, 1983-2021 by the American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).  

References 

1. Centers for Medicare and Medicaid Services. Local Coverage Determination (LCD): Surgical Dressings (L33831). Available at: https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=33831. Updated June 19, 2020. Accessed February 16, 2021. 

2. Centers for Medicare and Medicaid Services. Local Coverage Article: Surgical Dressings – Policy Article (A54563). Available at: https://www.cms.gov/medicare-coverage-database/details/article-details.aspx?articleId=54563&ver=35&MCDIndexType=6&mcdtypename=Compendia&CoverageSelection=Local&ArticleType=All&PolicyType=Final&s=All&KeyWord=Surgical+Dressings&KeyWordLookUp=Title&KeyWordSearchType=And&bc=gAAAAAgAAAAA&. Updated October 7, 2020. Accessed February 16, 2021.