{"id":8483,"date":"2019-02-04T09:08:12","date_gmt":"2019-02-04T03:38:12","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=8483"},"modified":"2026-05-11T10:58:51","modified_gmt":"2026-05-11T10:58:51","slug":"top-5-outpatient-reimbursement-questions-for-wound-care","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/top-5-outpatient-reimbursement-questions-for-wound-care\/","title":{"rendered":"Top 5 Questions Regarding Outpatient Reimbursement for Wound Care"},"content":{"rendered":"

Do outpatient reimbursement for Wound Care challenges frustrate you a lot? Medicare reimbursement regulations that are currently impacting wound care practices. Wound care professionals still have to follow the coding, payment, and coverage regulations for submitting claims to traditional Medicare.<\/p>\n

Issues in Outpatient Reimbursement for Wound Care:<\/h2>\n

Q. 1: Why it is crucial to know whether the outpatient wound clinic is a hospital-based outpatient wound care department or just a wound clinic?<\/strong><\/p>\n

When patients are examined in a hospital-based outpatient wound care clinic they receive 2 bills i.e. one from HOPD and another from QHP.<\/p>\n

Hence; the patients are seen by a QHP in his or her office, the patients and Medicare only receive one bill. Patients should be informed about whether they should expect one or two bills.<\/p>\n

Q. 2: There\u2019s always coding confusion and diagnoses typically need to be updated \u2013 how to do that?<\/strong><\/p>\n

Codes for products, procedures\/services, and diagnoses are typically updated on an annual basis, although some codes for drugs\/biologics and coding edits (see below) may be modified on a quarterly basis. Two major coding regulations are impacting the wound care industry and deserve special attention from wound care professionals:<\/p>\n