Today’s Wound Clinic 2020 Year in Review

This annual retrospective takes a look back at the best of TWC in 2020 and counts down the top 10 most read articles from the year.

As the new year and new decade began, several authors broached the topic of coming changes in health care. Caroline E. Fife, MD, FAAFP, CWS, FUHM, took a look at how wound care would change, focusing on hyperbaric oxygen therapy (HBOT) and prior authorization, and how private office settings affect care. Jayesh B. Shah, MD, MSc, UHM (ABPM), CWSP, FAPWCA, FCCWS, FACHM FUHM, FACP, explored how the Centers for Medicare and Medicaid Services (CMS) ruled that all outpatient services in the hospital would be under general supervision. Don Stephens and Justin Rightmer provided a guide to the new Outpatient Prospective Payment System (OPPS) rule.

The January issue explored Medicare Advantage in a comprehensive article by Helen B. Gelly, MD, FACCWS, UHM/ABPM, FUHM, who examined the impact of the plans and how preauthorization works. In Business Briefs, Kathleen D. Schaum kicked off the new year by suggesting five resolutions to make regarding revenue cycles.

February focused on physician office-based wound management. Dr. Shah offered a guide to wound clinics for handling obstacles to prior authorization. Telemedicine moved into increasing use in 2020, and TWC discussed how interprofessional internet consultations could improve patient care and lead to more revenue, in an article by Elaine H. Song, MD, PhD, MBA; Kye Evans, DO, FACEP; Scott Robinson, MD, Tiffany Hamm, BSN, RN, ACHRN, CWS; Jeff Mize, RRT, CHT, CWC; Catherine T. Milne, APRN, MSN, CWOCN-AP; Samantha Kuplicki, MSN, APRN-CNS, AGCNS-BC, CWS, CWCN-AP, RNFA; and Kathryn Whiston-Lemm, ACNP, CWCN, COCN-AP. In Let’s Be Frank, Frank Aviles Jr., PT, CWS, FACCWS, CLT, emphasized the importance of setting goals in the wound clinic to achieve objectives.  

In the March issue, TWC pondered the future of wound clinics, with several clinicians offering their insights on collaborative care, and how to withstand the ongoing modifications impacting wound care practice. Peter Sonnenreich, Mary Anne Dunkin, Lou Savant and Natalie Berry examined trends in diabetes and how they could affect wound clinics.

Bill Oldham and Robin Robinson explored the potential of regenerative medicine for wounds and burns in patients with diabetes. Traci A. Kimball, MD, CWSP, spoke about her experience with the Program of All-inclusive Care of the Elderly (PACE) model, an innovative model for wound care.

By the time the April issue arrived, the COVID-19 pandemic affected wound clinics and altered life in general, with several authors offering assistance and insights. Harriet Jones, MD, FACP, explored how wound clinics could minimize the spread of the coronavirus while continuing to provide effective wound care. Emphasizing the need to avoid potentially dire consequences, T. Samuel Nwafor, MD, FACP, FAPWCA, and Nancy Collins, PhD, RDN, LD, NWCC, FAND, offered guidance on providing safe care in a time of social distancing. Dr. Fife’s editorial urged practitioners and the public to show courage and fortitude during the pandemic. Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA, provided a practical guide to coding for patients with COVID-19. Ms. Schaum updated wound clinics on communication technology-based services during the pandemic.

Elsewhere in the April reimbursement issue, Ms. Cartwright looked at debridement and evaluation and management (E&M) clinic visits with Modifier -25. For Consultation Corner, Ms. Schaum explored the controversy over coding and billing for packages cellular- and tissue-based products (CTPs) received at “no cost.”

TWC investigated advanced technologies for wounds in the May issue. Windy Cole, DPM; and Stacey Coe, BA, CCRP, explored the potential of near-infrared spectroscopy to measure perfusion in diabetic foot ulcers (DFU). As rising numbers of HBOT centers operate without proper training, W.T. Workman, BS, MS, CAsP, CHT-A, FAsMA, FUHM, expounded on hyperbaric safety and training. How good is the cybersecurity in your wound clinic? Roger Shindell, MS, CHPS, CISA, CIPM, offered his advice.

As COVID-19 continued to spread, Ms. Schaum updated readers on telehealth requirement waivers. Shaun Carpenter, MD, FAPWCA, CWSP, pondered how to stay essential as a health care provider during the pandemic. Knicole Emanuel updated readers on the status of audits during COVID-19, while Diane Weiss, CPC, CPB, CHRI, wrote a practical guide to responding to an audit.

The June issue of TWC offered several perspectives on wound care in the time of COVID-19. Emphasizing preparation for the next wave of coronavirus infection, Lee C. Rogers, DPM, discussed how to prepare wound clinics, and developing a wound care without walls model post-pandemic. Mr. Shindell provided guidance on potential issues with HIPAA privacy and security during COVID-19. In a roundtable discussion, Pamela Scarborough, PT, DPT, MS, CWS, CEEAA; Carmen Hudson, MD, FACS, CWSP; Karen Lou Kennedy-Evans, RN, APRN-BC, FNP; and Jeanine Maguire, PT, MS, CWS; Misty Vaughn, PT, CWS, DAPWCA, offered advice on managing pressure injuries during the public health emergency.

As social distancing kept many patients out of doctors’ offices, Dr. Shah shared his experience in telemedicine and how the technology can be invaluable for patients and physicians. Ms. Schaum tested readers on their knowledge of telehealth coding.

Amputation was the focus of TWC’s July issue. Morgan McCoy, who underwent an above-knee amputation following an emergency, offered a compelling patient perspective of getting back to life after an amputation. Dr. Fife noted how CMS quality measures can help clinicians in screening for peripheral arterial disease (PAD) and preventing amputation, one leg at a time. Desmond Bell, DPM, CWS, FFPM RCPS (Glasgow), stressed the importance of restoring blood flow to preserve limbs. In treating patients with non-traumatic amputation, Kazu Suzuki, DPM, and Tiffany M. Chin, DPM, explored appropriate amputation levels and postoperative care.

Mr. Shindell provided more insights on HIPAA privacy and security in the workplace during COVID-19. Tobe Madu, BS, MSc, discussed how evolving data analytics can lead to better patient care.

Multidisciplinary wound care was the topic of the August issue. In a guest editorial, Dr. Fife interviewed her colleagues, Debi Thompson, RN, WCC; and Tara Stone, on how their team collaborates to provide effective multidisciplinary wound care. Dr. Collins emphasized the utility of vitamin D, the “sunshine vitamin,” in aiding wound healing through reducing inflammation and improving insulin resistance. Identifying bacteria in wounds is a key part of effective wound care, Eric Lullove, DPM, CWSP, FACCWS, FAPWCA, explored the potential of fluorescence imaging in an innovative device. Mr. Aviles provided an effective example of how patients benefit when they become active in their own care. Ms. Cartwright reviewed the new ICD-10-CM diagnoses codes so practitioners could prepare for their implementation.

Several expert authors tackled diabetic foot ulcers from various perspectives in the September issue. Given the importance of offloading DFUs to spur healing, James McGuire, DPM, PT, LPed, FAPWHc, and Barbara Aung, DPM, CWS, FAPWHc, reviewed best practices and discussed patient adherence to offloading. Dr. Aung also offered a closer look at effective remote monitoring devices for DFUs. Dr. Jones reviewed oral antihyperglycemic therapies for patients with diabetes. Efthymios Gkotsoulias, DPM, looked at DFUs from a surgical perspective.

Ms. Schaum continued to keep an eye on the COVID-19 pandemic, answering several reimbursement-related questions in Business Briefs. The September issue also included a patient handout on diabetic foot ulcers.

Legal issues anchored TWC’s October issue. Dr. Fife offered guidance on best practices in handling malpractice lawsuits over pressure injuries, and also shared her experience with meritless malpractice cases. Noting that miscommunication can be a key factor in malpractice suits, Laura Hale Brockway discussed tips for better communication among physicians. Tanya Babitch and Robin Desrocher expounded on legal tips for supervising advanced practice providers in the wound clinic.  

In November, TWC readers heard from a number of expert sources on pain management. Richard E. Maddy, PhD, shared his harrowing experience with his diagnosis of cutaneous polyarteritis nodosa and how doctors overlooked his excruciating pain. When treating patients with chronic pain, options are numerous, including opioids, non-opioid pharmacologics, targeted interventional therapies, and complementary and alternative medicine, noted an article by Caralin Schneider, BA; Scott Stratman, BS; Daniel Federman, MD; and Hadar Lev-Tov, MD, MAS. Survam Patel, PharmD, provided a practical guide to non-opioid pain treatments. Stefano Armando Biasi, BSc (cand); Vincent Maida, MD, MSc, BSc, CCFP (PC), FRCP (cand), explored the efficacy of cannabis-based medicines for wound pain.

Many attendees of Wound Clinic Business (WCB) will have an “aha!” moment when they learn something they didn’t know, which Ms. Schaum explored in Business Briefs. Dr. Cole and Asad Sohail, DPM, investigated the potential of amniotic tissue grafting for tissue necrosis induced by warfarin.

To wrap up the year, patient-centered decision making was the theme of the December issue. Dr. Fife explored the challenges of delivering HBOT in a way the centers the patient and not the disease. Emphasizing accommodating the patient’s needs, Susan Gallagher, PhD, RN, discussed treating lymphedema in patients with obesity, while Denise M. Baylor, OTR, LMT, CLT-LANA, CSWS, provided a practical guide to bandaging lymphedema in children. The Food and Drug Administration (FDA) is considering several new primary wound care endpoints in clinical trials, as detailed by Peggy Dotson, RN, BS. Following SAWC Fall’s successful virtual conference in November, Ms. Schaum answered questions related to her reimbursement session.

Finally, I informed readers that starting in January, TWC will be switching from a print to a digital publication. In addition to continuing to provide content focused on issues of interest to wound clinics, TWC will be posting more video content on a range of subjects, blogs from practitioners and thought leaders, and more Speaking of Wounds podcasts. Join us at this website for our bold new era.

Top 10 Most Read TWC Articles From 2020

10. An Auditor’s Perspective of Debridement and E&M/Clinic Visits With Modifier -25
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA

9. How COVID-19 Is Changing Wound Care and Why You Should Be Preparing Now for the Next Wave
Lee C. Rogers, DPM

8. How Wound Care May Change, for Better and Worse, in 2020
Caroline E. Fife, MD, FAAFP, CWS, FUHM

7. Offloading Diabetic Foot Ulcers With the Next Generation of Pressure Relief
Windy Cole, DPM; Stacey Coe, BA, CCRP

6. A Guide to Supervisory Requirements Following the 2020 OPPS Final Rule
Don Stephens and Justin Rightmer

5. Considerations and Recommendations Regarding the COVID-19 Virus for Wound Centers
Harriet Jones, MD, FACP

4. HIPAA Privacy and Security in the Workplace During the COVID-19 Pandemic
Roger M. Shindell, MS, CHPS, CISA, CIPM

3. Are You Ready for the New ICD-10-CM Diagnosis Codes Effective October 1, 2020?
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA

2. ICD-10-CM Coding Guidelines for COVID-19
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA

1. HIPAA Privacy and Security During the COVID-19 Pandemic
Roger Shindell, MS, CHPS, CISA