Coding, Measuring, Claims Processing, and More ... - Wounds

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7/12/2011First Quarter 2011 Medically Unlikely Edits(MUEs): Add-On Codes50 sq cm subcutaneoustissue debrided 11042 11045OR 11042 11045 11045591 unit2 units1 unit1 unit1 unit50 sq cm of epidermisand dermis debrided 97597 97598OR 97597 97598 97598591 unit2 units1 unit1 unit1 unit27© 2011 Healthpoint Biotherapeutics HS1092-0511Impact of Skilled Nursing Facility (SNF)Consolidated Billing “Therapy” is consolidated into Medicare payment to SNFs 97597 and +97598 are considered ―sometimes therapy‖ codesby Medicare Physicians and HOPDs must enter into contracts with SNFS tobill the SNFs (rather than Medicare Part B) for 97597 and97598 services provided to patients covered byMedicare Part A28© 2011 Healthpoint Biotherapeutics HS1092-051114
7/12/2011Medicare Coverage29© 2011 Healthpoint Biotherapeutics HS1092-0511CPT ® Assistant Provider Guidance Surgical and medical debridement can be reported by anyqualified health care professional. ―They are not restricted to asingle type of health care professional.‖ REMEMBER: State Practice Acts and payers determine ifyour specialty is ―qualified‖ to perform surgical and medicaldebridements.30© 2011 Healthpoint Biotherapeutics HS1092-051115
Page 1 and 2: 7/12/2011Debridement 2011: An Updat
Page 3 and 4: 7/12/2011Disclaimer (continued)Phys
Page 5 and 6: 7/12/20112011 New Surgical Debridem
Page 7 and 8: 7/12/20112011 CPT ® Codes for Medi
Page 9 and 10: 7/12/2011Size and Code Selection Cl
Page 11 and 12: 7/12/2011Use Appropriate Codes When
Page 13: 7/12/20112010 vs. 2011 National Ave
Page 17 and 18: 7/12/2011Summary: Debridement 2011:

Coding, Measuring, Claims Processing, and More ... - Wounds

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