Reimbursement & Compliance
Important Call to Action: Influence Medicare Coverage for Cellular and/or Tissue Based Products
The Centers for Medicare & Medicaid Services (CMS) has recently announced that the Medicare Administrative Contractors (MACs) issued the collaborative propo...
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Reimbursement & Compliance
Expanding Care: Medicare's 2024 Coverage Update for Lymphedema Compression Treatment Items
Starting January 1, 2024, Medicare extended its coverage to include lymphedema compression treatment items for Medicare Part B patients. This long-awaited chang...
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Reimbursement & Compliance
Hyperbaric Oxygen Therapy - The 30 Day Requirement For Diabetic Foot Ulcer
Getting reimbursed for your services - preventing hyperbaric oxygen therapy (HBO) services Medicare denials when treating Diabetic Foot Ulcers (DFU)When denying...
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REIMBURSEMENT & COMPLIANCE
December 2023 Updates on CMS Hyperbaric Reimbursement Discrepancies
December 2023 UpdatesOn December 21 2023, CMS issued an update to the previously published payment for HBOT, correcting the unadjusted reimbursement rate for CP...
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Reimbursement & Compliance
Skin Substitutes - What's New in 2023? Are Major Updates Coming Up?
BackgroundAs announced in July of 2022,the Centers for Medicare and Medicaid Services (CMS) proposed several changes to their policies forskin substitute produc...
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Reimbursement & Compliance
A Roadmap to Medical Billing and Coding Audits for Wound Care Providers
Wound care providers can use this medical billing roadmap to improve their clinical documentation and comply with medical necessity and payer coverage policy re...
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Reimbursement & Compliance
How to set up and optimize your wound care formulary
Why set up and/or optimize your Institution’s Formulary?The goal of a wound care product formulary is to help all healthcare professionals who care and treat pa...
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CMS Medically Unlikely Edits (MUE)
Reimbursement & Compliance
CMS Medically Unlikely Edits (MUE)
INTRODUCTIONWhat exactly are Medically Unlikely Edits (MUE)? 
 "A MUE isa maximum number of Units of Service (UOS) allowable under most circumstances for a sing...
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CMS Targeted Probe and Educate for HBOT Codes 99183 & G0277
Reimbursement & Compliance
CMS Targeted Probe and Educate for HBOT Codes 99183 & G0277
Be aware and prepare for the Targeted Probe and Educate (TPE) review processThe goal of CMS's Targeted Probe and Educate program is to help providers and suppli...
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Know Your Place Of Service
Reimbursement & Compliance
Know Your Place Of Service
Why accurate reimbursement with place of service coding mattersInaccurate information on claims frequently leads to incorrect reimbursement and hassles when try...
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Reimbursement & Compliance
Obtaining Prior Authorization from Non-Medicare Carriers for Hyperbaric Oxygen Therapy
?INTRODUCTIONDenied claims due to unauthorized patient procedures or services can be a major loss in revenue. Although most medical offices and provider based d...
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