{"id":15617,"date":"2022-08-04T12:33:29","date_gmt":"2022-08-04T12:33:29","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=15617"},"modified":"2025-08-28T13:31:26","modified_gmt":"2025-08-28T13:31:26","slug":"avoiding-improper-medicare-payments-for-surgical-dressings","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/avoiding-improper-medicare-payments-for-surgical-dressings\/","title":{"rendered":"Avoiding Improper Medicare Payments for Surgical Dressings"},"content":{"rendered":"<h2 style=\"text-align: left;\"><strong>Improper Payment Reasons<\/strong><\/h2>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Durable Medical Equipment (DME) suppliers of surgical dressings and physicians submit claims for surgical dressings and CMS covers it under the surgical dressings benefit i.e., SSA Section 1861[s][5]. CMS recently published the Medicare Fee-for-Service (FFS) improper Medicare payment rate for surgical dressings for the 2020 reporting period. <\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">For this reporting period, the improper payment rate for surgical dressings was 67.3 percent, with a projected improper payment amount of over $194.9 million. For the 2020 reporting period, insufficient documentation accounted for 82.4 percent of improper Medicare payments for surgical dressings.<\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\"> Additional types of errors for surgical dressings in the 2020 reporting period were no documentation (1.9 percent), medical necessity (1.7 percent), incorrect coding (1.9 percent), and other (12.2 percent).\u00a0<\/span><\/p>\r\n<h2 style=\"text-align: left;\"><strong>Avoiding Improper Medicare Payments<\/strong><\/h2>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">All claims billed to Medicare require a written order or prescription from the treating practitioner as a condition for payment. The written order or prescription must meet the requirements outlined for the Standard Written Order (SWO). <\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Billing guidelines would require you to communicate an SWO to the supplier before claim submission. Certain items of Durable Medical Equipment, Prosthetics, Orthotics, &amp; Supplies (DMEPOS), require a Written Order Prior to Delivery (WOPD) of the item(s) to the patient.<\/span><\/p>\r\n<p style=\"text-align: left;\"><strong>Billing guidelines for surgical dressings would require an SWO containing all the following elements:<\/strong><\/p>\r\n<ul style=\"text-align: left;\">\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Patient\u2019s name or Medicare Beneficiary Identifier (MBI)<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Order Date<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">General description of item:<\/span>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Description can be either a general description (for example, wheelchair or hospital bed), an HCPCS code, an HCPCS code narrative, or a brand name and model number<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">For equipment: Besides the description of the base item, the SWO may include all concurrently ordered options, accessories, or other features separately billed or require an upgraded code (list each separately)<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">For supplies: Besides a description of the base item, the DMEPOS order or prescription may include all concurrently ordered supplies separately billed (list each separately)<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dispensed quantity, if applicable<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Treating practitioner name or National Provider Identifier (NPI)<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Treating practitioner\u2019s signature<\/span><\/li>\r\n<\/ul>\r\n<p style=\"text-align: left;\"><strong>This Medicare coverage guidance applies to surgical dressing claims:<\/strong><\/p>\r\n<ul style=\"text-align: left;\">\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Medicare covers surgical dressings when a qualifying wound is present. Medicare defines a qualifying wound as either:<\/span>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">The wound caused by, or treated by, a surgical procedure<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">After debridement of the wound, regardless of debridement technique (examples include, but aren\u2019t limited to, surgical, mechanical, chemical, or autolytic)<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<p style=\"text-align: left;\"><strong>Eligible products classified as surgical dressings include:<\/strong><\/p>\r\n<ul style=\"text-align: left;\">\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Primary dressings: Therapeutic or protective coverings applied directly to wounds or lesions either on the skin or caused by an opening to the skin.<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Secondary dressings: Needed materials that serve therapeutic or protective roles to secure a primary dressing. Examples of secondary dressings include items such as adhesive tape, roll gauze, bandages, and disposable compression material.<\/span><\/li>\r\n<\/ul>\r\n<p style=\"text-align: left;\"><strong>For first wound evaluations, the treating practitioner\u2019s medical record, nursing home, or home care nursing records must specify:<\/strong><\/p>\r\n<ul style=\"text-align: left;\">\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Type of qualifying wound\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Location, number, and size of qualifying wounds being treated with a dressing<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Whether dressing use is primary or secondary or for some non-covered use (for example, wound cleansing)<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Amount of drainage<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Type of dressing (for example, hydrocolloid wound cover, hydrogel wound filler)<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Size of dressing (if applicable)<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Number or amount used at 1 time<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Frequency of dressing change<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any other relevant clinical information<\/span><\/li>\r\n<\/ul>\r\n<h2 style=\"text-align: left;\"><strong>Other Guidelines<\/strong><\/h2>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Medicare requires clinical information that proves reasonable and necessary requirements in the policy on the type and quantity of surgical dressings provided in the patient\u2019s medical records. Medicare requires the treating practitioner (or their designee) to update this information monthly. <\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Medicare requires this evaluation of the patient\u2019s wound(s) unless there\u2019s documentation in the medical record that justifies why the treating practitioner can\u2019t conduct an evaluation within this timeframe and what other uses of monitoring methods evaluated the patient\u2019s need for ongoing dressing usage.<\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Medicare expects weekly wound evaluations for patients in a nursing facility or for patients with heavily draining or infected wounds. A nurse, treating practitioner, or other health care professional involved in the regular care of the patient can do the evaluation. <\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">This person may have no financial relationship with the supplier. This prohibition doesn\u2019t extend to treating practitioners who are also the supplier. <\/span><\/p>\r\n<p style=\"text-align: left;\"><strong>The weekly or monthly evaluation must include:<\/strong><\/p>\r\n<ul style=\"text-align: left;\">\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Type of each wound (for example, surgical wound, pressure ulcer, burn)<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wound(s) location<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wound size (length X width) and depth<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Amount of drainage<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any other relevant wound status information<\/span><\/li>\r\n<\/ul>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Medicare requires the supplier to document the source of that information and data obtained in the supplier\u2019s records. The frequency of recommended dressing changes depends on the type and use of surgical dressing. When healthcare professionals use combinations of primary dressings, secondary dressings, and wound filler, the change frequencies of individual products should be similar.<\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">For purposes of this policy, the product in contact with the wound decides to change frequency. Medicare doesn\u2019t consider using a combination of products with differing change intervals as reasonable and necessary. <\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">For example, it isn\u2019t reasonable and necessary to use a secondary dressing with weekly change frequency over a primary dressing with daily change interval. Medicare will deny claims as not reasonable and necessary.<\/span><\/p>\r\n<p style=\"text-align: left;\"><a href=\"https:\/\/www.medicalbillersandcoders.com\/\"><b>MedicalBillersandCoders (MBC)<\/b><\/a><span style=\"font-weight: 400;\"> is a leading revenue cycle company providing complete medical billing services. For any assistance required for <a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/durable-medical-equipment-medical-billing-services.html\">DME services<\/a>, contact us at <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a>\/ <a href=\"tel: 888-357-3226\">888-357-3226<\/a><\/span><\/p>\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Reference: <\/span><a href=\"https:\/\/www.cms.gov\/Outreach-and-Education\/Medicare-Learning-Network-MLN\/MLNProducts\/medicare-provider-compliance-tips\/medicare-provider-compliance-tips.html#Surgical\"><span style=\"font-weight: 400;\">Medicare Provider Compliance for Surgical Dressings<\/span><\/a><\/p>\r\n<h2 style=\"text-align: left;\"><strong>FAQs:<\/strong><\/h2>\r\n\r\n<div class=\"schema-faq wp-block-yoast-faq-block\">\r\n<div id=\"faq-question-1745572908876\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">1. What is the improper payment rate for surgical dressings?<\/strong>\r\n<p class=\"schema-faq-answer\">The improper payment rate for surgical dressings was 67.3% in the 2020 reporting period.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1745572935344\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">2. What are the main reasons for improper Medicare payments?<\/strong>\r\n<p class=\"schema-faq-answer\">Insufficient documentation accounted for 82.4% of improper payments, along with errors in coding and medical necessity.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1745572963620\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">3. What is a Standard Written Order (SWO)?<\/strong>\r\n<p class=\"schema-faq-answer\">An SWO is a written order from a practitioner that includes essential details for billing surgical dressings to Medicare.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1745573118025\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">4. What qualifies as a &#8220;qualifying wound&#8221; for coverage?<\/strong>\r\n<p class=\"schema-faq-answer\">A qualifying wound is one caused by a surgical procedure or present after debridement, regardless of the technique used.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1745573144456\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">5. How often should wound evaluations be documented?<\/strong>\r\n<p class=\"schema-faq-answer\">Wound evaluations should be documented monthly or weekly for patients in nursing facilities or with heavily draining wounds.<\/p>\r\n<\/div>\r\n<\/div>\r\n","protected":false},"excerpt":{"rendered":"<p>Improper Payment Reasons Durable Medical Equipment (DME) suppliers of surgical dressings and physicians submit claims for surgical dressings and CMS covers it under the surgical dressings benefit i.e., SSA Section 1861[s][5]. CMS recently published the Medicare Fee-for-Service (FFS) improper Medicare payment rate for surgical dressings for the 2020 reporting period. For this reporting period, the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":25886,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[3602,2540,2533,3605,908,3600,751,3507,12,3604,3601],"class_list":["post-15617","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-dme-billing-services","tag-avoiding-improper-payments","tag-billing-guidelines","tag-claim-submission","tag-dme-services","tag-durable-medical-equipment","tag-durable-medical-equipment-dme","tag-hcpcs-code","tag-leading-revenue-cycle-company","tag-medical-billing-services-2","tag-medicare-coverage-guidance","tag-medicare-fee-for-service-ffs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Avoiding Improper Medicare Payments for Surgical 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