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Reimbursement Library From A to Z
Looking for reimbursement information? Search a specific topic here and get all the answers. Click on an underlined article title for more.
Advanced Beneficiary Notice
Confusion Reigns: Advance Beneficiary Notice of Non-coverage July/August 2024
Are You Ready? The New Medicare Advance Beneficiary Notice (ABN) January/February 2009
Audits (External and Internal)
Lessons Learned During Recent SMRC Audits September 2023
How Does Your Electronic Record Measure Up Under Audit? March 2023
Medicare Administrative Contractors Are Audited and Auditing: Learn From the Results February 2023
Called to the Principal’s Office: My Experience With a TPE Audit February 2022
How to Develop a Recipe for a Medical Audit Tool November 2021
Forming a Plan for the Dreaded, Inevitable Audit February 2021
Have You Read Your Own Documentation Lately? January 2021
Update on Medicare/Medicaid Audits in the Wake of COVID-19 June 2020
Managing Today’s World of Audits June 2020
Successfully Navigating Today’s World of CMS Audits October 2019
Frequently Asked Questions Surrounding Medicare’s Targeted Probe and Educate Review Program May 2018
Determining What’s Broken with Your Wound Clinic Reimbursement & Implementing Required Fixes April 2018
Responding Appropriately to Governmental Inquiries Related to Healthcare Services & Reimbursement August 2016
4 Steps to Achieving Audit Success October 2015
Will You Be Able to Keep Your Medicare Payment After An Audit? October 2015
Why Audits Are Happening In Wound Care & How To (Maybe) Avoid Them October 2015
Understanding the Post-Payment Review Process October 2015
How to Prepare For Your Pending Audit October 2015
Tell Us Your Auditing Story October 2015
Preparing Yourself To Get Through An Audit Unscathed October 2012
How to Conduct Internal Audits in the Wound Care Clinic August 2012
Signs of an Impending Audit: Are You Waving Red Flags? August 2012
The ABCs of Wound Care Auditing August 2012
Ten Self-Audit Questions: Coordination of Care with Suppliers of Medical Products October 2011
How to Survive a Medicare Outpatient Audit for Wound Care Services September 2011
“Heads-Up” from the CERT Documentation Contractors’ Reports September 2011
Autologous Blood-Derived Products for Chronic, Non-Healing Wounds
Autologous Blood-Derived Products for Chronic, Non-Healing Wounds: Frequently Asked Reimbursement Questions September 2023
Mid-Year Reimbursement Updates for CTPs (Skin Substitutes) and PRP July 2022
Cellular and/or Tissue-Based Products (CTPs) for Skin Wounds [Skin Substitutes]
Just Because You Can Perform a Medical Services, Does Not Mean You Should! July/August 2024
You Are in the Wound/Ulcer Management Business, Not the CTP Application Business! May/June 2024
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Coding Challenge: Readers vs. Workshop Attendees April 2024
Medicare Coverage for Application of CTPs in Post-Acute Care Places of Service February 2024
The 2024 Medicare Final Payment Rules Have Been Released: Part 1 November 2023
CMS Withdraws Local Coverage Policy That Dramatically Restricted Access to CTPs (Skin Substitutes) September 2023
How Changes to CTPs Could Impact Providers and Patient Care September 2023
Wound Size Matters: Analysis of the New Restrictive Skin Substitute LCD Policy September 2023
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No” October 2023
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released October 2023
CTPs Continue to Make the News! June 2023
Questions About the Application of CTPs Continue May 2023
In 2023, Will CMS Assign HCPCS “A” or “Q” Codes to New CTPs? April 2023
Are You Prepared to Implement the 2023 CTP Final Rules? December 2022
Mid-Year Reimbursement Updates for CTPs (Skin Substitutes) and PRP July 2022
Alphabet Soup of Codes for CTPs [Skin Substitutes] for Skin Wounds April 2022
Questions About Coding and Payment for Application of CTPs Are on the Rise! July 2021
Q&A: What Information Is Required for 361 HCT/P Products to Obtain HCPCS Codes? May 2021
Controversy: Coding and Billing for Packaged CTPs Received at ‘No Cost’! April 2020
The Ever-Changing Reimbursement Landscape of CTPs for Skin Wounds December 2019
Avoiding CTP Denials Through Appropriate Revenue Cycle Management January 2019
Coder’s Insight: Documentation Elements & Audit Resource Guide for CTPs October 2018
CTPs & Pass-Through Status October 2018
Physicians & Other Qualified Healthcare Professionals Are Questioning Medicare Contractors’ Coverage of CTPs April 2017
Playing Musical Chairs with CTPs in 2015 January 2015
CTPs: From Coding & Payment Changes (Then) to Coverage Changes (Now) April 2014
Confusion Reigns: 2014 Coding, Coverage, & Payment for CTPs March 2014
Application of Skin Substitute Graft Procedure Codes Are Changing Again—For Physicians and Facilities! November/December 2011
Chronic Care Management Services
Consider Incorporating Principal Care Management Services Into Your Practice July 2023
Communication Technology-Based Services (CTBS)
The COVID-19 Public Health Emergency Waivers Q&A September 2022
Communication Technology-Based Services Reimbursement Update March 2021
April 30, 2020 Update: Communication Technology-Based Services During the COVID-19 Pandemic April 2020
Complex Chronic Care Management Services
Consider Incorporating Principal Care Management Services Into Your Practice July 2023
Compression
Application of Compression: Medicare Coding, Payment, & Coverage November/December 2012
Coding and Medicare Coverage Review: Unna Boot and Multilayered, Sustained, Graduated High Compression Systems Winter 2008
Consolidated Billing (Skilled Nursing Facilities and Home Health Agencies)
Just Because You Can Perform a Medical Services, Does Not Mean You Should! July/August 2024
Do You Have Contracts With Skilled Nursing Facilities? October 2020
COVID-19 Public Health Emergency Waivers
Telehealth Use Continues and Receives Further Medicare Payment January 2023
The COVID-19 Public Health Emergency Waivers Q&A September 2022
The COVID-19 Public Health Emergency Extension Also Applies to Telehealth August 2022
The COVID-19 Public Health Emergency, Coding Changes, and Coverage Changes Continue
February 2022
The COVID-19 Public Health Emergency, Coding Changes, and Coverage Changes Continue February 2022
Reimbursement-Related Questions as the COVID-19 PHE Continues September 2020
Test Your Knowledge: Coding for Telehealth Performed During the COVID-19 PHE June 2020
June 2, 2020 Update: Telehealth Waivers During COVID-19 Public Health Emergency June 2020
April 30, 2020 Update: Communication Technology-Based Services During the COVID-19 Pandemic April 2020
ICD-10-CM Coding Guidelines for COVID-19 April 2020
Debridement
Just Because You Can Perform a Medical Services, Does Not Mean You Should! July/August 2024
Do Not Report a Code If You Do Not Know the Rules July/August 2024
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Coding Challenge: Readers vs. Workshop Attendees April 2024
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No” October 2023
Why Is Debridement Coding Such a Mystery? May 2022
An Auditor’s Perspective of Debridement and E&M/Clinic Visits with Modifier -25 April 2020
Don’t Select Codes by the Payment Rate You Like January 2020
Medicare (Non) Coverage for Debridement: The WPS LCD and What We Really Need to Worry About November 2019
Test Your Knowledge of Debridement Coding, Coverage, & Payment July 2017
Reimbursement Tips for Bariatric Surgery & Various Forms of Debridement June/July 2014
2011 Debridement Codes and Payment: The Remaining Pieces of the Puzzle July/August 2011
2011 Debridement Codes Have Changed—Be Sure Your Wound Care Team Implements the Changes January/February 2011
Surgical Debridement Current Topics in Billing and Coding September/October 2009
Excision and Debridement Dilemmas for Inpatient and Outpatient Providers May/June 2009
Debridement Reminders Issued by OIG and Payors: Keeping Abreast of Recent Developments Fall 2007
Diagnosis Coding
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Implementation of New Diagnosis Codes: Irritant Contact Dermatitis in 2022 and Factors Influencing Care in 2023 July 2022
New ICD-10-CM Coding Guideline Updates for Fiscal Year 2022: Part 2 September 2021
A Self-Checklist of Medicare Reimbursement Basics August 2021
New ICD-10-CM Codes for Wound Management Fiscal Year 2022: Part 1 August 2021
Are You Ready for the New ICD-10-CM Diagnosis Codes Effective October 1, 2020? August 2020
What Is Your Wound Clinic’s Status of Converting to the New ICD-11-MMS Coding System? November 2019
A Closer Look at the New ICD-10-CM Codes for Wound Management in 2020 October 2019
Wound vs. Ulcer: Selecting the Correct Diagnosis Code August 2019
Diagnosis Coding Insight: ICD-10 Updates for Wound Care November 2018
New Wound Care ICD-10-CM Codes for Fiscal Year 2018 & Review of Frequently Forgotten Codes January 2018
ICD-10-CM & Wound Care Coding: Essential Tips for Today's Practice August 2017
Review of Responses to Reader Survey: ICD-10-CM Lessons Learned – Part 3 April 2016
Review of Responses to Reader Survey: ICD-10-CM Lessons Learned – Part 2 March 2016
Review of Responses to Reader Survey: ICD-10-CM Lessons Learned February 2016
ICD-10-CM Q&A: State of the Industry February 2016
Utilizing General Equivalence Mappings in the Wake of ICD-10-CM Transition February 2016
Proper Diagnosis Under ICD-10-CM: Don’t be a Coding ‘Minimalist’ February 2016
Wound Care Revenue Barriers in an ICD-10-CM Environment: Tips for QHPs & Coders February 2016
ICD-10-CM Lessons Learned: Examining Controversies in Pressure Ulcer Coding Post-Implementation February 2016
Review of LCDs Released After ICD-10-CM Conversion February 2016
ICD-10-CM & HIPAA: Not Such Strange Bedfellows February 2016
NCDs & LCDs Released With Covered ICD-10 Codes: Will Your Documentation Support Medical Necessity? May 2015
New Medicare Physician Payment Program Doesn’t Delay ICD-10-CM Implementation May 2015
Preparing Your Documentation for ICD-10-CM: The Countdown is On! October 2013
Wound Healing Through Medical Data: Get Ready for ICD-10-CM Classification Improvements September 2013
Integrating New/Updated Codes Into Your Business for 2013 January/February 2013
Call to Action: Start Preparing for ICD-10-CM December 2012
Diagnostic Imaging
The 2024 Medicare Final Payment Rules Have Been Released: Part 2 December 2023
Documentation
You Are in the Wound/Ulcer Management Business, Not the CTP Application Business! May/June 2024
New LCD and LCA Documentation Requirements for Application of CTPs August 2023
Do You Have a Compliant Electronic Health Record Documentation and Signature Process? March 2023
Medical Necessity: The “Magic Bullet” to Medicare Coverage October 2022
How Does Your Documentation Measure Up to Medicare Standards? Debridement 101 May 2021
Have You Read Your Own Documentation Lately? January 2021
Wound Care Documentation Case Study: Complications of a Graft March 2015
Reimbursement Tips for Bariatric Surgery & Various Forms of Debridement June/July 2014
Correct Orders and Documentation Determine Medicare Coverage and Payment June 2010
23 Tips on Improving Your Documentation March/April 2009
Lack of Documentation May Cause Loss of Dollars Spring 2008
Documentation: Clearing Up the Role of Compliance Spring 2008
Durable Medical Equipment Suppliers
The COVID-19 Public Health Emergency Waivers Q&A September 2022
Medicare Coverage & Payment of Outpatient Wound Care Supplies November 2017
DME Medicare Administrative Contractor LCDs Are Important to Qualified Healthcare Professionals Specializing in Wound Care May 2013
Learning From My DME Experience: Turning A Negative Into A Positive January/February 2012
Ten Self-Audit Questions: Coordination of Care with Suppliers of Medical Products October 2011
Read Medicare LCDs before You Order Products and Equipment for Home Use December 2010
DMEPOS Suppliers
The 2024 Medicare Final Payment Rules Have Been Released: Part 3 January 2024
Evaluation & Management and Clinic Visits
Coding Challenge: Readers vs. Workshop Attendees April 2024
Can Physicians Afford to Manage Chronic Ulcers With Multiple Comorbidities? March 2024
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released October 2023
Evaluation & Management for Office, Outpatient, and Home Visits December 2022
Why Are My Prolonged E/M Service Claims Denied by Medicare? October 2022
Evaluation & Management vs. Hospital Owned Outpatient Provider-Based Department Clinic Visits September 2021
Controversy: Clinic Visits, Evaluation & Management (E&M) Services, and Minor Procedures July 2020
When Should You Bill for an E&M or Clinic Visit and a Procedure on the Same Day? July 2018
E&M Codes With Procedures & NCCI Edits Dominated Discussions at SAWC October 2013
Clinic Visits and Evaluation and Management: Myths and Misperceptions June 2011
Fluorescence Vascular Angiography
Coding, Payment, & Coverage for Fluorescence Vascular Angiography June/July 2013
Fluorescence Imaging of Bacterial Load
Reimbursement Video: Coding and Documentation for the MolecuLight Procedure June 2022
Reimbursement Video Tip: What Diagnosis Codes Would I Use to Describe Imaging Findings? June 2022
Reimbursement Video Tip: Can I Perform the MolecuLight Procedure in Addition to Other Procedures? June 2022
Reimbursement Video Tip: Are There Place of Service Restrictions With the MolecuLight Procedure? June 2022
Fraud and Abuse
‘F’ is for Fraud: How to Avoid Medicare and Medicaid Fraud July 2021
Wound Care Practitioners Must Pay Attention to Fraud & Abuse Laws March 2017
Lessons to Learn From Federal Convictions of HBOT Fraud March 2015
Frequently Asked Questions and Reimbursement Updates
Coding Challenge: Readers vs. Workshop Attendees April 2024
A Self-Checklist of Medicare Reimbursement Basics August 2021
FAQs from the 2021 SAWC Spring Reimbursement Session July 2021
Answers to Questions Following the ‘How Do I Get Paid for That?’ SAWC Fall Reimbursement Session December 2020
‘Aha!’ Moments During 2020 Virtual Wound Clinic Business Seminars November 2020
There Is No Such Thing as a Dumb Question! October 2020
Reimbursement Pearls From Wound Clinic Business 2019 November 2019
Coding Compliance Self-Test March 2019
Potpourri of Reimbursement Facts & Reminders October 2016
Is the Product Separately Payable By Medicare Part B? April 2015
Medicare Payment Trends & Tips March 2015
Revealing Mid-Year Updates for QHPs & HOPDs June/July 2015
Addressing FAQs Related to New & Misunderstood Codes March 2015
Medical Necessity Tops Conversation Topics at SAWC Spring May 2014
Integrating New/Updated Codes Into Your Business for 2013 January/February 2013
Global Surgical Period
Coding Challenge: Readers vs. Workshop Attendees April 2024
The Global Surgical Package & Separate Physician Payment for Follow-Up Care June 2017
Postoperative Care Reporting Required During Global Surgical Period June 2017
Hierarchical Condition Categories (HCC) and Risk Adjustment Scores
How Your Hierarchical Condition Category Score Can Impact Your Wound Clinic’s Finances December 2019
Hierarchical Condition Categories & Risk-Adjustment Scores: An Outline December 2018
Home Health Prospective Payment System
The 2024 Medicare Final Payment Rules Have Been Released: Part 2 December 2023
Hospital Owned Outpatient Provider-Based Department (PBD)
Coding Challenge: Readers vs. Workshop Attendees April 2024
The 2024 Medicare Final Payment Rules Have Been Released: Part 1 November 2023
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released October 2023
PBDs Should Not Expect to Receive Separate Medicare Payment for Every Procedure Performed January 2023
The COVID-19 Public Health Emergency Waivers Q&A September 2022
A Potpourri of Outpatient Prospective Payment System (OPPS) Updates July 2020
Confusion Reigns: Modifiers and Medicare Payment for Off-Campus PBDs May 2020
CMS: Effective This Month, All Outpatient Services in the Hospital Will Be Under General Supervision January 2020
A Guide to Supervisory Requirements Following the 2020 OPPS Final Rule January 2020
Why APC Status Indicators and Private Payer Contracts Matter October 2019
A Closer Look At Negative Pressure Wound Therapy in PBDs July 2019
Integrated Outpatient Code Editor: An Underused Resource January 2019
Does Your Wound Care PBD Correctly Charge for Inpatient Services? December 2017
Reimbursement Tips for Launching Your New Wound Care Clinic October 2017
Working in a Wound Care Provider-Based Department: The Medical Director’s Perspective August 2017
Lack of Correct Charges & Claim Submission Impacting HOPDs February 2017
Pay Attention to 2017 Final Rule About On-Campus & Off-Campus Provider-Based HOPDs January 2017
What Happened to the Outpatient Prospective Payment System Status Indicators This Year? September 2016
HOPD Charges Drive Medicare Payment Rates! August 2016
How Does Medicare Decide If Your HOPD is Provider-Based? July 2016
New Year Brings 5 New Skin Procedures APC Groups January 2016
10 Preparation Steps for Charge Description Masters in 2015 November/December 2014
2014 Revenue Cycle Components Will Affect Medicare Payment in 2016 September 2014
Why Were My HOPD Claims Denied? August 2014
HOPD Payment Changes Continue in 2014 January/February 2014
HOPDs: Prepare for ‘Payment Packaging’ November/December 2013
CMS Continues to Educate Wound Care Providers: Are We Paying Attention? September 2013
Understanding Medicare Payment Changes for HOPDs and Physicians in 2013 March 2013
Wound Clinic Reimbursement: “The Devil is in the Details” January/February 2012 Reimbursement Reminders for a Successful 2010—Happy New Year! February 2010
Final 2010 Medicare Policy: Supervision in HOPDs November/December 2009
Reimbursement Reminder Calendar September/October 2009
Focus on the Practice Management Process Summer 2008
Top 10 Concerns: Challenges to Consider as You’re Getting Started Spring 2007
Hyperbaric Oxygen Therapy
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Coding Challenge: Readers vs. Workshop Attendees April 2024
Correcting Common Bad Habits That Cause Medicare Denials and/or Repayments for HBOT September 2019
ICD-10 Coding for Soft Tissue Radiation Necrosis Treated with HBOT March 2019
Hyperbaric Medicine’s New Specialty Coding January 2019
Wound Care & Hyperbaric Insights: Revenue Cycle Tips for New Wound Care Clinics October 2018
The New Near Future of Hyperbaric Medicine Regulation: Targeted Probe and Educate March 2018
Frequently Asked Questions About HBOT Reimbursement March 2018
Hyperbaric Medicine Quality Reporting: Building an Ark to Ensure Survival March 2018
The Expanding Scope of Prepayment Review for Hyperbaric Oxygen Therapy February 2017
Uncharted Territory: Site Neutrality & Hyperbaric Therapy January 2017
Prior Authorization & Nonemergent HBOT: Update for Providers in Outpatient Wound Care October 2015
HBOT Documentation Paramount, Especially with Prior Authorization Looming October 2014
Hyperbaric Oxygen Therapy Reimbursement Reminders for a Successful 2010 April 2010
Let NCDs and LCDs Guide the Way to HBO Reimbursement Fall 2008
Imaging Studies
Have You Correctly Added Imaging Study Codes to Your Charging System? March 2022
“Incident-to” and Physician Supervision
Legal Tips for Physician Supervision of Advanced Practice Providers October 2020
Direct Supervision Requirements in PBDs April 2019
Test Your Knowledge of 'Incident To' & 'Direct Supervision' June 2018
Direct Supervision in the Provider-Based Department: What’s Required? May 2017
Arrange for “Direct Supervision” Before Scheduling Patients March 2011
Final 2010 Medicare Policy: Supervision in HOPDs November/December 2009
Infusion Therapy
The Business Side of Infusion Therapy: An Interview with a Coding Expert April 2012
Interprofessional Telephone/Internet/EHR Consultations
During the COVID-19 Pandemic, Have You Considered Interprofessional Technology-Based Consultations? August 2020
Local Coverage Determinations/Local Coding Articles
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Payers Continue to Release Pertinent Coverage Policies December 2021
Should You Believe ‘Word-of-Mouth’ or Payer’s Policies? July 2021
MAC and Wound Management Stakeholder Report Cards for New LCD and LCD Reconsideration Processes May 2019
Medicare Coverage When There Are No NCDs, LCDs, or Related Articles February 2019
Have You Committed to Participate in the New Local Coverage Determination Process? November 2018
Wound Care Professionals Influence Medicare Payment & Coverage for Advanced Treatment March 2016
Review of LCDs Released After ICD-10-CM Conversion February 2016
DME Medicare Administrative Contractor LCDs Are Important to Qualified Healthcare Professionals Specializing in Wound Care May 2013
Wound Care Coverage Playbook May 2011
The Surgical Dressing Policy: Still Alive and Well May 2011
Read Medicare LCDs before You Order Products and Equipment for Home Use December 2010
Manufacturers Provide Reimbursement Reminders to Podiatrists and Wound Departments August 2010
Keeping Up With Coverage March/April 2009
Lymphedema
The 2024 Medicare Final Payment Rules Have Been Released: Part 3 January 2024
The Secrets to Optimal Lymphedema Reimbursement January 2024
Medical Necessity
You Are in the Wound/Ulcer Management Business, Not the CTP Application Business! May/June 2024z
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Medical Necessity: The “Magic Bullet” to Medicare Coverage October 2022
Medicare Advantage
Taking a Critical Look at Medicare Advantage January 2020
Medicare Cards
New Medicare Cards: What, Why, When, & How to Prepare September 2017
Medicare Appeals Process
Navigating the Medicare Appeals Process November/December 2015
Medicare Physician Fee Schedule
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
“Allowed” and “Allowable” Do Not Mean Payment is Always Allowed January 2024
The 2024 Medicare Final Payment Rules Have Been Released: Part 2 December 2023
The 2024 Medicare Final Payment Rules Have Been Released: Part 1 November 2023
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No” October 2023
Medicare Resources
Do Not Report a Code If You Do Not Know the Rules July/August 2024
Medicare Tools, Education, and Resources for Professionals, Providers, and Manufacturers April 2020
Modifiers
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released October 2023
Confusion Reigns: Modifiers and Medicare Payment for Off-Campus PBDs May 2020
An Auditor’s Perspective of Debridement and E&M/Clinic Visits with Modifier -25 April 2020
Ready! Set! Report! Patient Relationship Modifiers June 2019
Use Modifier -25 Sparingly January 2017
National Correct Coding Initiative Edits
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Coding Challenge: Readers vs. Workshop Attendees April 2024
“Allowed” and “Allowable” Do Not Mean Payment is Always Allowed January 2024
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No” October 2023
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released October 2023
NCCI Edit Files & The Data Filter February 2019
2018 NCCI Policy Manual & Edits February 2018
Negative Pressure Wound Therapy
Who Will Medicare Separately Pay for Negative Pressure Wound Therapy? September/October 2024
FAQ: Medicare Reimbursement for Negative Pressure Wound Therapy September 2019
Parallel Paths to Medicare Reimbursement: Surgical Dressings & NPWT Pumps (Traditional and Disposable) August 2013
Correct Orders and Documentation Determine Medicare Coverage and Payment for Negative Pressure Wound Therapy June 2010
Nursing Facilities
Medicare Coverage for Application of CTPs in Post-Acute Care Places of Service February 2024
Outpatient Prospective Payment System
“Allowed” and “Allowable” Do Not Mean Payment is Always Allowed January 2024
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No” October 2023
Patients' Homes
Medicare Coverage for Application of CTPs in Post-Acute Care Places of Service February 2024
Payer Advocacy
Medical Professionals: Don’t Miss an Opportunity to Educate Payers May 2021
Wound Care Professionals Influence Medicare Payment & Coverage for Advanced Treatment March 2016
Physicians and Other Qualified Healthcare Professionals
Do Not Report a Code If You Do Not Know the Rules July/August 2024
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic May/June 2024
Coding Challenge: Readers vs. Workshop Attendees April 2024
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released October 2023
The COVID-19 Public Health Emergency Waivers Q&A September 2022
Reimbursement Changes Enable Expansion into a Variety of Places of Service January 2021
Exploring New Opportunities for Physicians to Expand Their Reach August 2019
Wound Care Physician Insights: Changing Compensation Models October 2018
Physician Practice Management Insights: Revenue Cycle Tips When Beginning Your Practice October 2018
Physicians and NPPs: Maintain Medicare Referring, Ordering, & Supervising Capabilities April 2013
Understanding Medicare Payment Changes for HOPDs and Physicians in 2013 March 2013
The Business of Wound Care: The Physician’s Perspective March 2012
Reimbursement Reminder Calendar September/October 2009
Place of Service
Medicare Coverage for Application of CTPs in Post-Acute Care Places of Service February 2024
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No” October 2023
It’s Time to Submit Your Claim: Did You Report the Correct Place of Service Code? June 2022
Business Briefs: Are You Reporting the Correct Outpatient Site of Care? June 2016
Qualified Healthcare Professionals: Prepare for New & Revised POS Codes September 2015
Principal Care Management Services
Consider Incorporating Principal Care Management Services Into Your Practice July 2023
Reimbursement Education
Quality Payment Programs
The Uphill Path to Value-Based Wound Care with Nutritional Assessment July 2019
Hyperbaric Medicine Quality Reporting: Building an Ark to Ensure Survival March 2018
My Quality Measure To-Do List January 2018
Capturing Quality Wound Care Under MIPS August 2017
Keeping ‘Skin in The Game’ for the Quality Payment Program June 2017
Thoughts From the Eye of the Healthcare Storm Part 2: The Wound Care Clinician’s Road Map to MACRA & MIPS March 2017
Thoughts from the Eye of the Healthcare Storm Part 1: The HOPD’s Role in Reporting Quality Measures March 2017
Realities of a New Payment System From the Physician & HOPD Perspective March 2017
The Wound Care Clinician’s Road Map to MACRA & MIPS March 2017
Taking ‘Our Own Medicine’ Through the Nutritional Screening Quality Measure & Quality Payment Program January 2017
Providing an Overview of the New Quality Payment Program November 2016
Quality Assurance Resource Guide: MACRA & MIPS are Fixable Problems for Wound Care Specialists August 2016
Quality Measures Resource Guide: How to Transition from Fee-for-Service to Value-Based Payments April 2016
Reimbursement Crystal Ball: Wound Care Models in Value-Based Payment April 2016
Self-Reporting of PQRS Measures in 2016: What You Choose to Report Does Matter! April 2016
Physician Quality Reporting System Checklist for Wound Care Providers: The Art of Documentation and Reporting April 2016
Understanding Business Profitability with Changing Models of Wound Care Reimbursement April 2016
Next Generation ACO Model: Conversation With Industry Executives April 2016
How to Transition From Fee-For-Service to Value-Based Payments April 2016
The Brave New World of Medicare Physician Payment: The Quality & Resource Use Report and What You Must do before March January 2016
The Wound Care Clinician’s Quality Reporting Survival Guide March 2015
Measuring Quality in Wound Care January/February 2013
Is Your Wound Clinic Prepared to Provide Care Under Parallel Reimbursement? October 2012
The Changing Face of Wound Care: Measuring Quality October 2012
Measuring Quality In Wound Care November/December 2011
Remote Physiologic Monitoring and Remote Therapeutic Monitoring
The 2024 Medicare Final Payment Rules Have Been Released: Part 2 December 2023
The COVID-19 Public Health Emergency Waivers Q&A September 2022
What Is the Difference Between RPM and RTM? January 2022
Remote Physiologic Monitoring Reimbursement Update April 2021
Revenue Cycle Management
Pay Attention to Code Descriptions or Lose/Repay Money! October 2021
Revenue Challenges: Don’t Be Your Own Worst Enemy! October 2021
Do You Know the Members of Your Revenue Cycle Team? April 2021
Share 2020 Payment Information with Your Clinical and Revenue Cycle Teams March 2020
Share New Codes with Your Clinical and Revenue Cycle Teams February 2020
Make These 5 Revenue Cycle Resolutions for 2020 January 2020
Don’t Select Codes by the Payment Rate You Like January 2020
Is Medicare’s Reimbursement Timeline Incorporated Into Your Calendar? October 2019
Charges Do Not Magically Appear on Medicare Claims July 2019
Wound Care & Hyperbaric Insights: Revenue Cycle Tips for New Wound Care Clinics October 2018
Wound Care Stakeholders’ Insights: Revenue Management Cycle October 2018
Reimbursement Strategy Insight: New Products & HCPCS Codes October 2018
Determining What’s Broken with Your Wound Clinic Reimbursement & Implementing Required Fixes April 2018
Are You Reporting the Correct Outpatient Site of Care? June 2016
Are You Prepared to Answer Questions About New Medicare Summary Notices? June/July 2012
Is This Wound Clinic Financially Successful? And Where Can I Find Medicare Payment Regulations? July/August 2009
Realizing Revenue from a Wound Clinic Summer 2008
Signatures
Do You Have a Compliant Electronic Health Record Documentation and Signature Process? March 2023
Skilled Nursing Facilities
Just Because You Can Perform a Medical Services, Does Not Mean You Should! July/August 2024
Medicare Coverage for Application of CTPs in Post-Acute Care Places of Service February 2024
Do Physicians/QHPs Really Need a Written Agreement With Skilled Nursing Facilities? July 2022
Do You Have Contracts With Skilled Nursing Facilities? October 2020
Smoking Cessation Counseling
Business Briefs: Smoking Cessation Counseling: Coding, Payment, & Coverage May 2016
Surgical Dressings
Parallel Paths to Medicare Reimbursement: Surgical Dressings & NPWT Pumps (Traditional and Disposable) August 2013
The Surgical Dressing Policy: Still Alive and Well May 2011
Telehealth
The 2024 Medicare Final Payment Rules Have Been Released: Part 2 December 2023
Telehealth Use Continues and Receives Further Medicare Payment January 2023
The COVID-19 Public Health Emergency Waivers Q&A September 2022
The COVID-19 Public Health Emergency Extension Also Applies to Telehealth August 2022
Telehealth Reimbursement Update February 2021
Test Your Knowledge: Coding for Telehealth Performed During the COVID-19 PHE June 2020
June 2, 2020 Update: Telehealth Waivers During COVID-19 Public Health Emergency June 2020
Is Telehealth On Your Radar Screen? April 2019
Therapy
Just Because You Can Perform a Medical Services, Does Not Mean You Should! July/August 2024
Reimbursement for Outpatient Biophysical Procedures and Equipment May 2012
2011 Medicare Payment for Therapists in Wound Clinics April 2011
Total Contact Casting
Reimbursement for Total Contact Casting: Fighting the Financial Burden October 2010
Wound/Ulcer Management Business Marketing
When Wound Care Marketing & Reimbursement Payments Collide August 2019
Wound/Ulcer Management Certification
How Does Reimbursement Change with Wound Care Certification? September 2018
Wound/Ulcer Management Throughout the Continuum of Care
A Vision for Enhancing Wound Clinics' Business Model June 2021
Coordination of Care in Volume-Based & Value-Based Payment Systems March 2017
Special Report: CareMore Focuses on Treating the ‘Whole’ Senior Citizen August 2015
