Alonso MC, Mohammed HT, Fraser RD, Ramirez Garcia Luna JL, Mannion D, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2023 Oct 1;volume 35(10):E330-E338.
1. Wounds. 2023 Oct;35(10):E330-E338. doi: 10.25270/wnds/23031.
Comparison of wound surface area measurements obtained using clinically
validated artificial intelligence-based technology versus manual methods and the
effect of measurement method on debridement code reimbursement cost.
Alonso MC(1), Mohammed HT(2), Fraser RD(3), Ramirez Garcia Luna JL(4), Mannion
D(2).
Author information:
(1)Abrazo Health Care, Arizona US.
(2)Swift Medical Inc, Toronto, Ontario, Canada.
(3)Swift Medical Inc, Toronto, Ontario, Canada; Western University, Arthur
Labatt Family School of Nursing, London, Ontario, Canada.
(4)McGill University, Montreal, Quebec, Canada.
BACKGROUND: Evidence shows that ongoing accurate wound assessments using valid
and reliable measurement methods is essential to effective wound monitoring and
better wound care management. Relying on subjective interpretation in measuring
wound dimensions and assuming a rectilinear shape of all wounds renders an
inconsistent and inaccurate wound area measurement.
OBJECTIVE: The authors investigated the discrepancy in wound area measurements
using a DWMS versus TPR methods and compared debridement codes submitted for
reimbursement by assessment method.
METHODS: The width and length of 177 wounds in 56 patients were measured at an
outpatient clinic in the United States using the TPR method (width × length
formula) and a DWMS (traced wound dimensions). The maximal allowable payment for
debridement was calculated for both methods using the reported CPT codes based
on each 20-cm2 estimated surface area.
RESULTS: The average wound surface area was significantly higher with the TPR
method than with the DWMS (20.20 and 12.81, respectively; P = .025). For
patients with dark skin tones, ill-defined wound edges, irregular wound shapes,
unhealthy tissues, and the presence of necrotic tissues, the use of the DWMS
resulted in significantly lower mean differences in wound area measurements of
14.4 cm2 (P < .008), 8.2 cm2 (P = .040), 6.8 cm2 (P = .045), 13.1 cm2 (P =
.036), and 7.6 cm2 (P = .043), respectively, compared with the TPR method. Use
of the DWMS for wound surface area measurement resulted in a 10.6% lower
reimbursement amount for debridement, with 82 fewer submitted codes, compared
with the TPR method.
CONCLUSIONS: Compared with the DWMS, TPR measurements overestimated wound area
more than 36.6%. This overestimation was associated with dark skin tones and
wounds with irregular edges, irregular shapes, and necrotic tissue.
DOI: 10.25270/wnds/23031
PMID: 37956346 [Indexed for MEDLINE]
