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Table of Contents

Reimbursement Topic Center

Reimbursement Library From A to Z
02/04/2022
Looking for reimbursement information? Search a specific topic here and get all the answers.
Looking for reimbursement information? Search a specific topic here and get all the answers.
Looking for reimbursement...
02/04/2022
Today's Wound Clinic

The Latest in Business Briefs

Business Briefs
Confusion Reigns: Advance Beneficiary Notice of Non-coverage
07/19/2024
Misinformation about the use of an advanced beneficiary notice (ABN) of non-coverage is spreading like wildfire. This author presents the most common scenarios reported, answers to the ABN inquiries, and appropriate uses for ABNs.
Misinformation about the use of an advanced beneficiary notice (ABN) of non-coverage is spreading like wildfire. This author presents the most common scenarios reported, answers to the ABN inquiries, and appropriate uses for ABNs.
Misinformation about the use of...
07/19/2024
Today's Wound Clinic
Business Briefs
Physicians, QHPs, and MACs Complain About Some Billing Companies
06/18/2024
Kathleen D. Schaum, MS
I thought readers would be interested in what a “good” billing company looks like. Amiee Coriano, the owner of AMC Medical Consulting, LLC, agreed to share how her coding and billing company operates and circumvents client complaints.
I thought readers would be interested in what a “good” billing company looks like. Amiee Coriano, the owner of AMC Medical Consulting, LLC, agreed to share how her coding and billing company operates and circumvents client complaints.
I thought readers would be...
06/18/2024
Today's Wound Clinic
Business Briefs
You Are in the Wound/Ulcer Management Business, Not the CTP Application Business!
05/23/2024
Kathleen D. Schaum, MS
Because most denials and repayments of CTPs are due to lack of thorough wound/ulcer management documentation, I was excited to have this opportunity to remind SAWC Spring attendees that they are in the wound/ulcer management business, not the...
Because most denials and repayments of CTPs are due to lack of thorough wound/ulcer management documentation, I was excited to have this opportunity to remind SAWC Spring attendees that they are in the wound/ulcer management business, not the...
Because most denials and...
05/23/2024
Today's Wound Clinic
Business Briefs
Coding Challenge: Readers vs. Workshop Attendees
04/26/2024
Kathleen D. Schaum, MS
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs...
04/26/2024
Today's Wound Clinic
Business Briefs
Can Physicians Afford to Manage Chronic Ulcers With Multiple Comorbidities?
03/29/2024
Kathleen D. Schaum, MS
Because G2211 appeared to be an unknown code to these ulcer management professionals, it may be unknown to the readers. This author addresses the questions she was asked about the appropriate use of G2211.
Because G2211 appeared to be an unknown code to these ulcer management professionals, it may be unknown to the readers. This author addresses the questions she was asked about the appropriate use of G2211.
Because G2211 appeared to be an...
03/29/2024
Today's Wound Clinic

Sponsored Videos

MolecuLight
Videos
HOPD Coding and Medicare Payment for MolecuLight Real-Time Fluorescence Wound Imaging for Bacterial Presence, Location, and Load
11/09/2023

Featuring Kathleen D. Schaum, MS

Featuring Kathleen D. Schaum, MS ...
Kathleen D. Schaum, MS, offers practical reimbursement insights for MolecuLight real-time fluorescence.
Kathleen D. Schaum, MS, offers practical reimbursement insights for MolecuLight real-time fluorescence.
Kathleen D. Schaum, MS, offers...
11/09/2023
Today's Wound Clinic
Reimbursement Video: Coding and Documentation for the MolecuLight Procedure
Video
Reimbursement Video: Coding and Documentation for the MolecuLight Procedure
06/09/2022

Sponsored Content

Sponsored Content
Coding and documentation tips for the MolecuLight procedure for “real-time fluorescence wound imaging for bacterial presence, location, and load.”
Coding and documentation tips for the MolecuLight procedure for “real-time fluorescence wound imaging for bacterial presence, location, and load.”
Coding and documentation tips...
06/09/2022
Today's Wound Clinic
Reimbursement Video Tip: What Diagnosis Codes Would I Use to Describe Imaging Findings?
Video
Reimbursement Video Tip: What Diagnosis Codes Would I Use to Describe Imaging Findings?
06/09/2022

Sponsored Content

Sponsored Content
A quick reimbursement video tip that answers the question, “What diagnosis codes would I use to describe imaging findings?" This question relates to the MolecuLight Procedure for “real-time fluorescence wound imaging for bacterial presence,...
A quick reimbursement video tip that answers the question, “What diagnosis codes would I use to describe imaging findings?" This question relates to the MolecuLight Procedure for “real-time fluorescence wound imaging for bacterial presence,...
A quick reimbursement video tip...
06/09/2022
Today's Wound Clinic
Reimbursement Video Tip: Can I Perform the MolecuLight Procedure in Addition to Other Procedures?
Video
Reimbursement Video Tip: Can I Perform the MolecuLight Procedure in Addition to Other Procedures?
06/09/2022

Sponsored Content

Sponsored Content
A quick reimbursement video tip that answers the question, “Can I perform the MolecuLight Procedure in addition to other procedures?" This question relates to the MolecuLight Procedure for “real-time fluorescence wound imaging for bacterial...
A quick reimbursement video tip that answers the question, “Can I perform the MolecuLight Procedure in addition to other procedures?" This question relates to the MolecuLight Procedure for “real-time fluorescence wound imaging for bacterial...
A quick reimbursement video tip...
06/09/2022
Today's Wound Clinic
Reimbursement Video Tip: Are There Place of Service Restrictions With the MolecuLight Procedure?
Video
Reimbursement Video Tip: Are There Place of Service Restrictions With the MolecuLight Procedure?
06/09/2022

Sponsored Content

Sponsored Content
A quick reimbursement video tip that answers the question, “Are there place of service restrictions with the MolecuLight Procedure?" This question relates to the MolecuLight Procedure for “real-time fluorescence wound imaging for bacterial...
A quick reimbursement video tip that answers the question, “Are there place of service restrictions with the MolecuLight Procedure?" This question relates to the MolecuLight Procedure for “real-time fluorescence wound imaging for bacterial...
A quick reimbursement video tip...
06/09/2022
Today's Wound Clinic

CTPs

Business Briefs
You Are in the Wound/Ulcer Management Business, Not the CTP Application Business!
05/23/2024
Kathleen D. Schaum, MS
Because most denials and repayments of CTPs are due to lack of thorough wound/ulcer management documentation, I was excited to have this opportunity to remind SAWC Spring attendees that they are in the wound/ulcer management business, not the...
Because most denials and repayments of CTPs are due to lack of thorough wound/ulcer management documentation, I was excited to have this opportunity to remind SAWC Spring attendees that they are in the wound/ulcer management business, not the...
Because most denials and...
05/23/2024
Today's Wound Clinic
Consultation Corner
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic
05/09/2024
Kathleen D. Schaum, MS
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19,...
05/09/2024
Today's Wound Clinic
Business Briefs
Coding Challenge: Readers vs. Workshop Attendees
04/26/2024
Kathleen D. Schaum, MS
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs...
04/26/2024
Today's Wound Clinic
Business Briefs
Medicare Coverage for Application of CTPs in Post-Acute Care Places of Service
02/16/2024
Kathleen D. Schaum, MS
Including an Interview with Martha R. Kelso, RN, CHWS, HBOT
Including an Interview with Martha R. Kelso, RN, CHWS, HBOT
Including an Interview with...
02/16/2024
Today's Wound Clinic

Telehealth

Business Briefs
The 2024 Medicare Final Payment Rules Have Been Released: Part 2
12/13/2023
Kathleen D. Schaum, MS
This Part 2 article will review a few other new 2024 payment regulations, such as OPPS, RPM and RTM, telehealth, and home health.
This Part 2 article will review a few other new 2024 payment regulations, such as OPPS, RPM and RTM, telehealth, and home health.
This Part 2 article will review...
12/13/2023
Today's Wound Clinic
Business Briefs
Telehealth Use Continues and Receives Further Medicare Payment 
01/25/2023
Kathleen D. Schaum, MS
The COVID-19 PHE has been extended for 90 more days. This author reviews the Medicare telehealth flexibility extensions that may be important to wound/ulcer management professionals.
The COVID-19 PHE has been extended for 90 more days. This author reviews the Medicare telehealth flexibility extensions that may be important to wound/ulcer management professionals.
The COVID-19 PHE has been...
01/25/2023
Today's Wound Clinic
Business Briefs
The COVID-19 Public Health Emergency Waivers Q&A
09/07/2022
Kathleen D. Schaum, MS
This author answers more questions about what will happen to telehealth and other waivers when the COVID-19 PHE ends.
This author answers more questions about what will happen to telehealth and other waivers when the COVID-19 PHE ends.
This author answers more...
09/07/2022
Today's Wound Clinic
Business Briefs
The COVID-19 Public Health Emergency Extension Also Applies to Telehealth
08/15/2022
Kathleen D. Schaum, MS
The COVID-19 Public Health Emergency (PHE) is extended through October 13, 2022. Many wound/ulcer management professionals have been using telehealth and should be happy to know that the Medicare waivers pertaining to telehealth have also...
The COVID-19 Public Health Emergency (PHE) is extended through October 13, 2022. Many wound/ulcer management professionals have been using telehealth and should be happy to know that the Medicare waivers pertaining to telehealth have also...
The COVID-19 Public Health...
08/15/2022
Today's Wound Clinic

FAQs and Reimbursement Updates

Business Briefs
Coding Challenge: Readers vs. Workshop Attendees
04/26/2024
Kathleen D. Schaum, MS
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs...
04/26/2024
Today's Wound Clinic
Business Briefs
A Self-Checklist of Medicare Reimbursement Basics
08/03/2021
Kathleen D. Schaum, MS
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
08/03/2021
Today's Wound Clinic
Business Briefs
FAQs from the 2021 SAWC Spring Reimbursement Session
06/04/2021
Kathleen D. Schaum, MS
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
06/04/2021
Today's Wound Clinic
Business Briefs
Answers to Questions Following the ‘How Do I Get Paid for That?’ SAWC Fall Reimbursement Session
12/02/2020
Kathleen D. Schaum, MS
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
12/02/2020
Today's Wound Clinic

Diagnosis Coding

Consultation Corner
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic
05/09/2024
Kathleen D. Schaum, MS
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19,...
05/09/2024
Today's Wound Clinic
New Diagnosis Codes
Implementation of New Diagnosis Codes: Irritant Contact Dermatitis in 2022 and Factors Influencing Care in 2023
07/07/2022
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA
Please ensure that all providers of wound/ulcer management in your facility are aware of the new codes and encourage them to appropriately document the conditions so the coders can easily identify the various types of irritant contact...
Please ensure that all providers of wound/ulcer management in your facility are aware of the new codes and encourage them to appropriately document the conditions so the coders can easily identify the various types of irritant contact...
Please ensure that all providers...
07/07/2022
Today's Wound Clinic
ICD-10-CM Codes
New ICD-10-CM Codes for Wound Management Fiscal Year 2022: Part 1
08/10/2021
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA
In the 2022 version of ICD-10-CM, there are a total of 72,748 codes, including 159 additions, 32 deletions, and 20 revisions.
In the 2022 version of ICD-10-CM, there are a total of 72,748 codes, including 159 additions, 32 deletions, and 20 revisions.
In the 2022 version of...
08/10/2021
Today's Wound Clinic
Are You Ready for the New ICD-10-CM Diagnosis Codes Effective October 1, 2020?
ICD-10-CM
Are You Ready for the New ICD-10-CM Diagnosis Codes Effective October 1, 2020?
08/04/2020
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
08/04/2020
Today's Wound Clinic

Hospital Owned Outpatient Provider-Based Departments

Business Briefs
Coding Challenge: Readers vs. Workshop Attendees
04/26/2024
Kathleen D. Schaum, MS
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs...
04/26/2024
Today's Wound Clinic
Business Briefs
The 2024 Medicare Final Payment Rules Have Been Released: Part 1
11/21/2023
Kathleen D. Schaum, MS
Now that both the 2024 OPPS and MPFS Final Rules have been released, this Part 1 article will provide the correct payment information regarding CTPs and will provide a brief overview of the 2024 allowable rates for other common wound/ulcer...
Now that both the 2024 OPPS and MPFS Final Rules have been released, this Part 1 article will provide the correct payment information regarding CTPs and will provide a brief overview of the 2024 allowable rates for other common wound/ulcer...
Now that both the 2024 OPPS and...
11/21/2023
Today's Wound Clinic
Business Briefs
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released
10/20/2023
Kathleen D. Schaum, MS
This article reviews some errors that caused claim denials and repayments this year. These errors and subsequent denials/repayments are easily avoided. Simply share the information with your team and agree to tighten up your coding and...
This article reviews some errors that caused claim denials and repayments this year. These errors and subsequent denials/repayments are easily avoided. Simply share the information with your team and agree to tighten up your coding and...
This article reviews some errors...
10/20/2023
Today's Wound Clinic
Consultation Corner
PBDs Should Not Expect to Receive Separate Medicare Payment for Every Procedure Performed
01/20/2023
Kathleen D. Schaum, MS
A medical director and department director of a large PBD contracted with the author to help them identify why the actual 2022 revenue of the PBD fell significantly short of their chief financial officer’s projections. Learn more about this...
A medical director and department director of a large PBD contracted with the author to help them identify why the actual 2022 revenue of the PBD fell significantly short of their chief financial officer’s projections. Learn more about this...
A medical director and...
01/20/2023
Today's Wound Clinic

Hyperbaric Oxygen Therapy

Consultation Corner
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic
05/09/2024
Kathleen D. Schaum, MS
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19,...
05/09/2024
Today's Wound Clinic
Business Briefs
Coding Challenge: Readers vs. Workshop Attendees
04/26/2024
Kathleen D. Schaum, MS
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs...
04/26/2024
Today's Wound Clinic
Business Briefs
Correcting Common Bad Habits That Cause Medicare Denials and/or Repayments for HBOT
09/04/2019
Kathleen D. Schaum, MS
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
09/04/2019
Today's Wound Clinic
ICD-10-CM
ICD-10 Coding for Soft Tissue Radiation Necrosis Treated with HBOT
03/11/2019
Valerie J. Short, RN, ACHRN, CWCN, CWS, CMBS, FACCWS
There have been many challenges for everyone in the health care profession related to the implementation of ICD-10, which took effect on October 1, 2015. Fortunately, the field of hyperbaric medicine had a very short list of covered...
There have been many challenges for everyone in the health care profession related to the implementation of ICD-10, which took effect on October 1, 2015. Fortunately, the field of hyperbaric medicine had a very short list of covered...
There have been many challenges...
03/11/2019
Today's Wound Clinic

Reimbursement Check-Up Quizzes

Quiz
Reimbursement Check-Up: Have You Correctly Added Imaging Study Codes to Your Charging System?
03/02/2022
Take this quiz after reading the March 2022 Business Briefs.
Take this quiz after reading the March 2022 Business Briefs.
Take this quiz after reading the...
03/02/2022
Today's Wound Clinic
Quiz
Reimbursement Check-Up: Continuation of COVID-19 Public Health Emergency, Coding Changes, and Coverage Changes
02/24/2022
Take this quiz after reading the February 2022 Business Briefs column.
Take this quiz after reading the February 2022 Business Briefs column.
Take this quiz after reading the...
02/24/2022
Today's Wound Clinic
Quiz
Reimbursement Check-Up: Coding and Payment for Application of CTPs
07/23/2021
Take this quiz after reading the July 2021 Business Briefs column.
Take this quiz after reading the July 2021 Business Briefs column.
Take this quiz after reading the...
07/23/2021
Today's Wound Clinic

The Latest in Consultation Corner

Consultation Corner
Do Not Report a Code If You Do Not Know the Rules
07/30/2024
In this quarter alone, I consulted with 50+ professionals, providers, and suppliers who were paid by Medicare, but failed post-payment audits. In most instances, the stakeholders could have prevented the repayments.
In this quarter alone, I consulted with 50+ professionals, providers, and suppliers who were paid by Medicare, but failed post-payment audits. In most instances, the stakeholders could have prevented the repayments.
In this quarter alone, I...
07/30/2024
Today's Wound Clinic
Consultation Corner
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic
05/09/2024
Kathleen D. Schaum, MS
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19,...
05/09/2024
Today's Wound Clinic
Consultation Corner
“Allowed” and “Allowable” Do Not Mean Payment is Always Allowed
01/30/2024
Kathleen D. Schaum, MS
I received multiple consulting requests from wound/ulcer management professionals whose 2023 year-end financial results were well below their projections. Yet their volume of business aligned with their projections. This Consultation Corner...
I received multiple consulting requests from wound/ulcer management professionals whose 2023 year-end financial results were well below their projections. Yet their volume of business aligned with their projections. This Consultation Corner...
I received multiple consulting...
01/30/2024
Today's Wound Clinic
Consultation Corner
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No”
10/26/2023
Kathleen D. Schaum, MS
Because wound/ulcer management is performed by a variety of medical professionals, for a wide range of wounds and ulcers, for patients in various places of service and who have a wide variety of insurance plans with disparate coverage and...
Because wound/ulcer management is performed by a variety of medical professionals, for a wide range of wounds and ulcers, for patients in various places of service and who have a wide variety of insurance plans with disparate coverage and...
Because wound/ulcer management...
10/26/2023
Today's Wound Clinic

Documentation

Business Briefs
You Are in the Wound/Ulcer Management Business, Not the CTP Application Business!
05/23/2024
Kathleen D. Schaum, MS
Because most denials and repayments of CTPs are due to lack of thorough wound/ulcer management documentation, I was excited to have this opportunity to remind SAWC Spring attendees that they are in the wound/ulcer management business, not the...
Because most denials and repayments of CTPs are due to lack of thorough wound/ulcer management documentation, I was excited to have this opportunity to remind SAWC Spring attendees that they are in the wound/ulcer management business, not the...
Because most denials and...
05/23/2024
Today's Wound Clinic
Documentation
New LCD and LCA Documentation Requirements for Application of CTPs
08/23/2023
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA
To ensure continued success for your practices, this author sincerely hopes that stakeholders affected by these new LCDs and LCAs will review and refine their documentation of skin substitute/CTP applications prior to September 17, 2023....
To ensure continued success for your practices, this author sincerely hopes that stakeholders affected by these new LCDs and LCAs will review and refine their documentation of skin substitute/CTP applications prior to September 17, 2023....
To ensure continued success for...
08/23/2023
Today's Wound Clinic
Business Briefs
Do You Have a Compliant Electronic Health Record Documentation and Signature Process?
03/31/2023
Kathleen D. Schaum, MS
This author poses 4 signature scenarios/questions 1) in an interview with Donna Cartwright, MPA, RHIA, CCS, RAC, FAHIMA, a consultant who has a wealth of experience performing wound/ulcer management medical record reviews, and 2) to one of...
This author poses 4 signature scenarios/questions 1) in an interview with Donna Cartwright, MPA, RHIA, CCS, RAC, FAHIMA, a consultant who has a wealth of experience performing wound/ulcer management medical record reviews, and 2) to one of...
This author poses 4 signature...
03/31/2023
Today's Wound Clinic
Business Briefs
Medical Necessity: The “Magic Bullet” to Medicare Coverage
10/15/2022
Kathleen D. Schaum, MS
If the medical necessity “why” is missing or non-convincing, now is the time to use the “magic bullet” to coverage by taking the steps required to improve your written and/or EHR documentation.
If the medical necessity “why” is missing or non-convincing, now is the time to use the “magic bullet” to coverage by taking the steps required to improve your written and/or EHR documentation.
If the medical necessity “why”...
10/15/2022
Today's Wound Clinic

COVID-19 Public Health Emergency Waivers

Business Briefs
Telehealth Use Continues and Receives Further Medicare Payment 
01/25/2023
Kathleen D. Schaum, MS
The COVID-19 PHE has been extended for 90 more days. This author reviews the Medicare telehealth flexibility extensions that may be important to wound/ulcer management professionals.
The COVID-19 PHE has been extended for 90 more days. This author reviews the Medicare telehealth flexibility extensions that may be important to wound/ulcer management professionals.
The COVID-19 PHE has been...
01/25/2023
Today's Wound Clinic
Business Briefs
The COVID-19 Public Health Emergency Waivers Q&A
09/07/2022
Kathleen D. Schaum, MS
This author answers more questions about what will happen to telehealth and other waivers when the COVID-19 PHE ends.
This author answers more questions about what will happen to telehealth and other waivers when the COVID-19 PHE ends.
This author answers more...
09/07/2022
Today's Wound Clinic
Business Briefs
The COVID-19 Public Health Emergency Extension Also Applies to Telehealth
08/15/2022
Kathleen D. Schaum, MS
The COVID-19 Public Health Emergency (PHE) is extended through October 13, 2022. Many wound/ulcer management professionals have been using telehealth and should be happy to know that the Medicare waivers pertaining to telehealth have also...
The COVID-19 Public Health Emergency (PHE) is extended through October 13, 2022. Many wound/ulcer management professionals have been using telehealth and should be happy to know that the Medicare waivers pertaining to telehealth have also...
The COVID-19 Public Health...
08/15/2022
Today's Wound Clinic
Business Briefs
The COVID-19 Public Health Emergency, Coding Changes, and Coverage Changes Continue
02/09/2022
Kathleen D. Schaum, MS
For this month, let us review the continuation of the COVID-19 public health emergency (PHE), and the continuation of the ever-changing codes and coverage.
For this month, let us review the continuation of the COVID-19 public health emergency (PHE), and the continuation of the ever-changing codes and coverage.
For this month, let us review...
02/09/2022
Today's Wound Clinic

Audits (External and Internal)

Audits
How Does Your Electronic Record Measure Up Under Audit? 
03/31/2023
Donna J. Cartwright, MPA, RHIA, CCS, RAC, FAHIMA
As a result of an interview that I did with Kathleen Schaum in the latest Business Briefs on electronic signatures, I felt the need to convey to our readers some of the issues I have seen when auditing electronic health records (EHRs)...
As a result of an interview that I did with Kathleen Schaum in the latest Business Briefs on electronic signatures, I felt the need to convey to our readers some of the issues I have seen when auditing electronic health records (EHRs)...
As a result of an interview that...
03/31/2023
Today's Wound Clinic
Business Briefs
Medicare Administrative Contractors Are Audited and Auditing: Learn From the Results
02/23/2023
Kathleen D. Schaum, MS
Although CERT audits are not focused directly on professionals, providers, and suppliers, these stakeholders should not ignore CERT audit record requests. This author looks at the major repayment reasons to learn from the 2022 CERT report.
Although CERT audits are not focused directly on professionals, providers, and suppliers, these stakeholders should not ignore CERT audit record requests. This author looks at the major repayment reasons to learn from the 2022 CERT report.
Although CERT audits are not...
02/23/2023
Today's Wound Clinic
Guest Editorial
Called to the Principal’s Office: My Experience With a TPE Audit
02/22/2022
David Charash, DO, CWS, FACEP, FUHM
Any audit can be stressful but it should not be traumatic. Proactive advanced preparation and planning will be your best defense against any audit from a third party.
Any audit can be stressful but it should not be traumatic. Proactive advanced preparation and planning will be your best defense against any audit from a third party.
Any audit can be stressful but...
02/22/2022
Today's Wound Clinic
Business Briefs
How to Develop a Recipe for a Medical Audit Tool
11/08/2021
Kathleen D. Schaum, MS
Michael Crouch, CHT, CPC, CPMA
Kathleen D. Schaum, MS, interviews Michael Crouch, CHT, CPC, CPMA, an independent consultant to wound care programs nationwide, about the steps of designing an internal audit tool.
Kathleen D. Schaum, MS, interviews Michael Crouch, CHT, CPC, CPMA, an independent consultant to wound care programs nationwide, about the steps of designing an internal audit tool.
Kathleen D. Schaum, MS,...
11/08/2021
Today's Wound Clinic

Revenue Cycle Management

Consultation Corner
Pay Attention to Code Descriptions or Lose/Repay Money!
10/12/2021
Kathleen D. Schaum, MS
A lack of knowledge about the codes and coding guidelines caused physicians to lose money and to repay money during the recent post-payment audit.
A lack of knowledge about the codes and coding guidelines caused physicians to lose money and to repay money during the recent post-payment audit.
A lack of knowledge about the...
10/12/2021
Today's Wound Clinic
Business Briefs
Revenue Challenges: Don’t Be Your Own Worst Enemy!
10/04/2021
Kathleen D. Schaum, MS
Many revenue challenges for wound/ulcer management professionals and providers are self-imposed but there are some major revenue cycle process challenges that can be easily rectified.
Many revenue challenges for wound/ulcer management professionals and providers are self-imposed but there are some major revenue cycle process challenges that can be easily rectified.
Many revenue challenges for...
10/04/2021
Today's Wound Clinic
Do You Know the Members of Your Revenue Cycle Team?
Consultation Corner
Do You Know the Members of Your Revenue Cycle Team?
04/05/2021
Kathleen D. Schaum, MS
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
04/05/2021
Today's Wound Clinic
Business Briefs
Share 2020 Payment Information With Your Clinical and Revenue Cycle Teams
03/05/2020
Kathleen D. Schaum, MS
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
03/05/2020
Today's Wound Clinic
Share New Codes with Your Clinical and Revenue Cycle Teams
Business Briefs
Share New Codes with Your Clinical and Revenue Cycle Teams
02/03/2020
Kathleen D. Schaum, MS
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and...
Information regarding coding,...
02/03/2020
Today's Wound Clinic

Debridement

Consultation Corner
Do Not Report a Code If You Do Not Know the Rules
07/30/2024
In this quarter alone, I consulted with 50+ professionals, providers, and suppliers who were paid by Medicare, but failed post-payment audits. In most instances, the stakeholders could have prevented the repayments.
In this quarter alone, I consulted with 50+ professionals, providers, and suppliers who were paid by Medicare, but failed post-payment audits. In most instances, the stakeholders could have prevented the repayments.
In this quarter alone, I...
07/30/2024
Today's Wound Clinic
Consultation Corner
New Wound/Ulcer Management Practices Started During the COVID-19 Pandemic Are Now Having a Reimbursement Pandemic
05/09/2024
Kathleen D. Schaum, MS
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19, many physicians and QHPs started offering wound/ulcer management in their offices, in skilled nursing facilities, in non–skilled nursing facilities, and even in patients’ homes. Unfortunately, many of the new...
Throughout and after COVID-19,...
05/09/2024
Today's Wound Clinic
Business Briefs
Coding Challenge: Readers vs. Workshop Attendees
04/26/2024
Kathleen D. Schaum, MS
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs...
04/26/2024
Today's Wound Clinic
Consultation Corner
Most Reimbursement Questions Cannot Be Answered With a Simple “Yes” or “No”
10/26/2023
Kathleen D. Schaum, MS
Because wound/ulcer management is performed by a variety of medical professionals, for a wide range of wounds and ulcers, for patients in various places of service and who have a wide variety of insurance plans with disparate coverage and...
Because wound/ulcer management is performed by a variety of medical professionals, for a wide range of wounds and ulcers, for patients in various places of service and who have a wide variety of insurance plans with disparate coverage and...
Because wound/ulcer management...
10/26/2023
Today's Wound Clinic

Evaluation & Management and Clinic Visits

Business Briefs
Coding Challenge: Readers vs. Workshop Attendees
04/26/2024
Kathleen D. Schaum, MS
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs are failing their pre-payment and post-payment audits due to noncompliance with these basic wound/ulcer management codes. Take the coding test pertaining to common wound/ulcer management services/procedures...
Many PBDs, physicians, and QHPs...
04/26/2024
Today's Wound Clinic
Business Briefs
Can Physicians Afford to Manage Chronic Ulcers With Multiple Comorbidities?
03/29/2024
Kathleen D. Schaum, MS
Because G2211 appeared to be an unknown code to these ulcer management professionals, it may be unknown to the readers. This author addresses the questions she was asked about the appropriate use of G2211.
Because G2211 appeared to be an unknown code to these ulcer management professionals, it may be unknown to the readers. This author addresses the questions she was asked about the appropriate use of G2211.
Because G2211 appeared to be an...
03/29/2024
Today's Wound Clinic
Business Briefs
Make Sure to Comply With Existing Rules Before the 2024 Final Rules Are Released
10/20/2023
Kathleen D. Schaum, MS
This article reviews some errors that caused claim denials and repayments this year. These errors and subsequent denials/repayments are easily avoided. Simply share the information with your team and agree to tighten up your coding and...
This article reviews some errors that caused claim denials and repayments this year. These errors and subsequent denials/repayments are easily avoided. Simply share the information with your team and agree to tighten up your coding and...
This article reviews some errors...
10/20/2023
Today's Wound Clinic
Business Briefs
Evaluation & Management for Office, Outpatient, and Home Visits
12/16/2022
Kathleen D. Schaum, MS
Because wound/ulcer management physicians and QHPs perform most of their E/M service work in their offices, hospital owned outpatient wound/ulcer management PBDs, and in patients’ homes, this author answers questions about reporting E/M...
Because wound/ulcer management physicians and QHPs perform most of their E/M service work in their offices, hospital owned outpatient wound/ulcer management PBDs, and in patients’ homes, this author answers questions about reporting E/M...
Because wound/ulcer management...
12/16/2022
Today's Wound Clinic

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