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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

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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
Consultation Corner
Manufacturers: Have You Provided Reimbursement Strategy Education for Your Executives and Sales Representatives?
07/26/2023
Kathleen D. Schaum, MS
Manufacturers should arrange ongoing reimbursement education for their executives and sales representatives. The goal should be first to learn how to position their products clinically, and second to position their products in alignment with...
Manufacturers should arrange ongoing reimbursement education for their executives and sales representatives. The goal should be first to learn how to position their products clinically, and second to position their products in alignment with...
Manufacturers should arrange...
07/26/2023
Today's Wound Clinic
Consultation Corner
PBDs Should Select and Report Use of CTPs Carefully
05/02/2023
Kathleen D. Schaum, MS
Because coding misinformation is common, this consultant often receives calls from PBD stakeholders who report large volumes of denied CTP claims. Hopefully, this consultation will provide facts that will prevent PBDs from encountering the...
Because coding misinformation is common, this consultant often receives calls from PBD stakeholders who report large volumes of denied CTP claims. Hopefully, this consultation will provide facts that will prevent PBDs from encountering the...
Because coding misinformation is...
05/02/2023
Today's Wound Clinic

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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
Consultation Corner
Why Are My Prolonged E/M Service Claims Denied by Medicare?
10/21/2022
Kathleen D. Schaum, MS
This real-life consultation describes what happened when a physician who provides wound/ulcer management in her office and in a hospital owned outpatient wound/ulcer management provider-based department inappropriately reported the new...
This real-life consultation describes what happened when a physician who provides wound/ulcer management in her office and in a hospital owned outpatient wound/ulcer management provider-based department inappropriately reported the new...
This real-life consultation...
10/21/2022
Today's Wound Clinic
Consultation Corner
Do Physicians/QHPs Really Need a Written Agreement With Skilled Nursing Facilities?
07/21/2022
Kathleen D. Schaum, MS
The real-life consultation below describes what usually happens when a physician/QHP does not have a written agreement prior to beginning work in a SNF.
The real-life consultation below describes what usually happens when a physician/QHP does not have a written agreement prior to beginning work in a SNF.
The real-life consultation below...
07/21/2022
Today's Wound Clinic

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Consultation Corner
Is Professional Consultation Billable to Medicare?
04/11/2022
Kathleen D. Schaum, MS
Unfortunately, this country has a shortage of chronic ulcer management professionals. Therefore, many physicians/QHPs who do not have the required knowledge do their best to manage chronic ulcers by trial and error.
Unfortunately, this country has a shortage of chronic ulcer management professionals. Therefore, many physicians/QHPs who do not have the required knowledge do their best to manage chronic ulcers by trial and error.
Unfortunately, this country has...
04/11/2022
Today's Wound Clinic

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Today's Wound Clinic Newsletter

Letter From the Editor

Guest Editorial
Advocate for Your Wound Care Patients on the Proposed MAC Policy on CTPs
05/29/2024
Eric J. Lullove, DPM, CWSP
The MACs recently released proposed coverage policy updates for applying CTPs for DFUs and VLUs. This is your opportunity to effect change by submitting comments to the MACs before the policy becomes final. You have a responsibility to know...
The MACs recently released proposed coverage policy updates for applying CTPs for DFUs and VLUs. This is your opportunity to effect change by submitting comments to the MACs before the policy becomes final. You have a responsibility to know...
The MACs recently released...
05/29/2024
Today's Wound Clinic
From the Editor
The Future of Wound Care in the Quality Payment Program
03/13/2024
Caroline E. Fife, MD, FAAFP, CWS, FUHM
Whether we will be able to survive as wound care practitioners will, at least in part, depend on having quality measures that are relevant to what we actually do.
Whether we will be able to survive as wound care practitioners will, at least in part, depend on having quality measures that are relevant to what we actually do.
Whether we will be able to...
03/13/2024
Today's Wound Clinic
From the Editor
The Non-Pressure Ulcer Episode-Based Cost Measure "Field Test" Began Feb. 1
02/05/2024
Caroline E. Fife, MD, FAAFP, CWS, FUHM
For years I have been explaining how the QPP could be the end of wound care practitioners. The entire QPP is designed around recognized medical specialties and since there is no recognized specialty for wound care, we are all in trouble.
For years I have been explaining how the QPP could be the end of wound care practitioners. The entire QPP is designed around recognized medical specialties and since there is no recognized specialty for wound care, we are all in trouble.
For years I have been explaining...
02/05/2024
Today's Wound Clinic
Guest Editorial
The G-Code Solution to Skin Substitute Reimbursement
01/25/2024
Shaun Carpenter MD, CWSP
I am calling on CMS to adopt new G codes to replace Q code reimbursement and CPT 15000 codes for skin substitute application procedures and to establish skin substitute product code classes.
I am calling on CMS to adopt new G codes to replace Q code reimbursement and CPT 15000 codes for skin substitute application procedures and to establish skin substitute product code classes.
I am calling on CMS to adopt new...
01/25/2024
Today's Wound Clinic
Guest Editorial
Wound Size Matters: Analysis of the New Restrictive Skin Substitute LCD Policy
09/01/2023
Shaun Carpenter MD, CWSP, WMS
With so much ambiguity remaining, an immediate compromise on the number of applications to allow 7 is warranted both from an ethical and medical perspective. The current restriction of 4 applications is clearly not based on an accurate...
With so much ambiguity remaining, an immediate compromise on the number of applications to allow 7 is warranted both from an ethical and medical perspective. The current restriction of 4 applications is clearly not based on an accurate...
With so much ambiguity...
09/01/2023
Today's Wound Clinic
Guest Editorial
Wrestling With Implicit Bias to Deliver Better Care for Our Patients
06/01/2023
Monique L. Abner, MD, CWSP
For some, bias remains a sensitive issue, and some people are reluctant to admit to the need for introspection. However, to mitigate the ill effects of bias, everyone must first acknowledge that it exists.
For some, bias remains a sensitive issue, and some people are reluctant to admit to the need for introspection. However, to mitigate the ill effects of bias, everyone must first acknowledge that it exists.
For some, bias remains a...
06/01/2023
Today's Wound Clinic
From the Editor
Confessions of a Doctor With Lipedema
03/14/2023
Caroline E. Fife, MD, FAAFP, CWS, FUHM
It is hard to understand how demoralizing it is. Lipedema affects your entire life, starting in the teenage years.
It is hard to understand how demoralizing it is. Lipedema affects your entire life, starting in the teenage years.
It is hard to understand how...
03/14/2023
Today's Wound Clinic
From the Editor
Why Won’t the DME Provide Dressings for My Patient?
02/23/2023
Caroline E. Fife, MD, FAAFP, CWS, FUHM
Maybe Because Of My Documentation
Maybe Because Of My Documentation
Maybe Because Of My...
02/23/2023
Today's Wound Clinic
Guest Editorial
How Wound Care Providers Can Treat Patients Like People, Not Like Cases
02/01/2023
Morgan McCoy
Finding a skilled wound care professional comes down finding someone who is confident in their skill/craft—someone who treats the whole patient, not just the wound. Finding someone who would see me as a person and a whole being rather than...
Finding a skilled wound care professional comes down finding someone who is confident in their skill/craft—someone who treats the whole patient, not just the wound. Finding someone who would see me as a person and a whole being rather than...
Finding a skilled wound care...
02/01/2023
Today's Wound Clinic
Guest Editorial
Amputations in Pyoderma Gangrenosum Patients: Underreported or Very Rare?
01/11/2023
Shannon Kody, MD
Alex G. Ortega-Loayza, MD, MCR
Are providers missing the diagnosis of PG because they are anchoring on “positive” biopsy findings? Could we be missing cases in which PG patients underwent amputation, didn’t have a recurrence, and were never diagnosed? Or are we just not...
Are providers missing the diagnosis of PG because they are anchoring on “positive” biopsy findings? Could we be missing cases in which PG patients underwent amputation, didn’t have a recurrence, and were never diagnosed? Or are we just not...
Are providers missing the...
01/11/2023
Today's Wound Clinic

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Coping With COVID-19

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

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