Reporting wound care encounters accurately and completely according to the ICD-10-CM and CPT® guidelines can be a challenge, as can navigating the rules around billing and payment for wound-related services. The introduction of new E/M coding guidelines for outpatient visits has added to the complexity. Wound care clinics also face increased scrutiny from Medicare and third-party payers regarding the reporting of debridement and cellular-based tissue products.

During this 90-minute webinar, Gloria Miller, CPC, CPMA, CPPM, will review the latest ICD-10-CM codes and coding guidelines applicable to wound care services. Miller will discuss best practices for wound care documentation, coding, and billing, and review substantial updates to the AMA’s E/M reporting guidelines. She will also discuss CPT coding for wound debridement and skin grafting, and provide billing advice to help listeners maximize reimbursement for these services. The presentation will be followed by a live Q&A.

Learning Objectives:-

• Locate appropriate diagnosis codes for wound care local coverage determinations
• Adhere to updated E/M reporting guidelines as they apply to wound care encounters
• Appropriately apply CPT codes and modifiers for wound care assessments
• Interpret complex pricing data for cellular-based tissue products

Agenda:-

• Medical necessity for wound care procedures
  • Documentation necessary to meet medical necessity
  • Finding diagnosis codes related to medical necessity
• 2021 ICD-10-CM wound care codes
  • New diabetes guideline for long-term insulin or oral hypoglycemic drugs
  • New codes for chronic kidney disease, glucose transporter deficiencies, and more
• Documentation and CPT/HCPCS coding for common wound procedures
  • CPT coding for wound debridement, skin grafts, and substitutes
• E/M coding and guideline updates 
  • Physician and hospital reporting of visit services for wound care management
  • Coding and billing for virtual encounters
• Distinct procedural service modifiers
  • Appropriate use of modifiers -25, -59, and -X{EPSU}
  • Coding examples from operative reports
• Medicare billing and payment for cellular-based tissue products
  • LCD coverage limitations and pricing for high- and low-cost skin substitutes
  • Best practices to ensure accurate reimbursement for these products

Who Should Attend?

• Clinical staff/wound care providers
• Outpatient coding managers and staff
• Physician coding managers and staff
• Wound care staff
• Compliance staff
• Chargemaster coordinators
• Finance staff
• Provider-based clinic billers and coders
• Revenue integrity staff