Wound care billing services in Texas: A boon for Medical Service Industry

August 17, 2016

Wound care billing services in Texas: A boon for Medical Service Industry

The need for outpatient wound care billing services in Texas is increasing by the day as facilities and hospitals are facing a tough time to control their bleeding accounts. With professional medical billing and coding agencies emerging as a viable option to tackle the issue, it's certainly become a boon for the medical service industry.

The billing for wound care service benefits generally includes a careful audit of the patient's medicinal record for the injury, including wound assessment, chronic diseases like diabetes, chronic ulcers, quadriplegia, and methodology offered to deal with the injury, follow up and visit, plus the photos of the injury, and wound progression.

In many cases a wound care facility is putting forth superb patient care, but healing rates are high. But, when the time comes of accounting the income, clinical staff is left oblivious. While great patient care is imperative, however a center that does not focus on bringing a certified medical billing and coding agency to handle the accounts may soon see its doors closed.

Wound care billing and coding in Texas is at the heart of each outpatient wound care program and is urgent to the survival of the practice. A recent survey conducted by Wound Care Advantage discovered $300,000 of lost billings for a center and more than $200,000 for another. One of the facilities was charging hyperbaric medications with wrong units for quite a long while.

Wound consideration procedures represent a huge rate of repayment income for healing center and doctors. In numerous offices, from a coding and billing viewpoint, payment/reimbursement for wound care administrations is an extraordinary challenge. Avoiding confusion is critical, particularly for the importance of wound care. But, from a coder's point of view, "wound consideration" includes wound treatment and in addition Evaluation and Management (E/M).

Additional coding issues that lead to irregular payment module for a wound care facility incorporate the following:

  • Utilization of hyperbaric oxygen when all other injury management modalities have fizzled not linked by doctor orders for the system and if they are not present for claim processing the case can be denied.
  • Inadequately billed documents of wound assessment fundamentally influences repayment, and if wound measurements are not present for case handling, the claim can be denied.
  • Perplexing specific and non-specific debridement
  • Wrong utilization of modifier 25 whether there is an independently billable administration
  • Coding various layers of debridement per site as opposed to coding the most profound layer for debridement. For instance, bone and muscle debridement can't be coded together for the same site.
  • Coding E/M levels for cases requiring G0463 for Medicare-particular cases; and Coding for dressing of wounds separate from an E/M administration.

All things considered, while conflicting reports exist about wound care administrations and wound consideration, it is required to comprehend that doctor or restorative work force documentation is critical to proper coding and billing for wound care administrations. Don't wait long before your Wound Care practice in Texas also shuts down due to irregular billing and coding practices. Outsource the services and feel the increment in your revenue cycle.


Category : Best Billing and Coding Practices