Knowledge Center
At Discount Wound Care, We have a mission to make practicing medicine more affordable while still providing high quality PDAC approved products to doctors and healthcare facilities nationwide.
- High Quality
- Fast Shipping
- Customer Service
Knowledge Center
Dispensing surgical dressings in your office can be rewarding in many ways, from streamlined patient care, better patient outcomes, and a revenue generating service that can make wound care more fulfilling for practitioners.
However along with anything that gets paid for by insurances, comes audits. A robust self-auditing program and documentation review should be a part of any surgical dressing dispensing program. Whether you’re looking at starting to dispense dressings, or want to review your current program, feel free to browse links and documents periodically.
DME License checklist and How to obtain
The first step for any DME dispensing is to enroll as a DMEPOS Supplier. Below is Medicare’s convenient 6 step program to obtaining a DME License.
https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/durable-medical-equipment-prosthetics-orthotics-supplies-dmepos
Pearls:
1- EACH location that orders and dispenses DME MUST have a separate DME license. For groups with multiple locations, providers cannot order DME from one location and have the patient go pick up at a different location.
2- Many small private practitioners may be exempt of needing the $50,000 surety bond, review the requirements carefully prior to obtaining one.
3- Make sure your business liability or renter’s insurance has the required Slip & Fall coverage.
Medicare LCDs
LCDs (Local Coverage Determination) are documents put out by Medicare MACs regarding whether a specific medical service or item is considered "reasonable and necessary" and therefore covered by Medicare within their geographic jurisdiction; essentially determining if a service is covered in a particular area based on local medical needs and standards.
It is extremely important to periodically review YOUR Medicare MAC’s documents for changes. Below are links to CGS and Noridian’s LCD and associated LCD policy articles.
Medicare LCD L33831 Surgical Dressings
https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33831&ver=48&keywordtype=
starts&keyword=surgical%20dre&bc=0
Medicare Policy Article A54563 for Surgical Dressings
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=54563&ver=54
Standard Documentation Requirements for All Claims Submitted to DME MACs
If it’s not documented, it didn’t happen! As well as the documentation requirements listed in the above LCD and Articles, there’s an additional policy Article A55426 for ALL the DME MACs that needs to be reviewed.
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55426&ver=117
Medicare (CGS) Provided Documentation Checklist
CGS puts out a comprehensive checklist for you to review your documentation, we highly recommended periodically reviewing your documentation with this checklist because it is what is used when audited.
https://www.cgsmedicare.com/jc/mr/
documentation_checklists.html
Free Documentation Review
If CGS is your carrier, they provide an excellent review of your documentation that can help dismiss future audits on your claim. This is a PRE-payment review, and takes around 10-14 business days. And using this service while starting out is a fantastic way to make sure you’re being compliant in your documentation.
https://www.cgsmedicare.com/jb/mr/
cgsconnect.html
Common Denial Reasons & Additional Resources
Top Denial Reasons
Additional Links to review
https://www.linkedin.com/pulse/dme-billing-podiatric-practice-things-consider-maurice-isserman
Example Authorization form for insurances
EMR Templates to Copy/Paste
Ulcer Debridement Template for Athenahealth
Collagen Dispensing Documenation for Athenahealth
Need additional assistance?
If you have a denial reason on a kit you purchased from us and you just can’t figure out, feel free to email our support staff at Guidance@discountwoundcare.com a redacted copy of your EOB and your questions and concerns!
Forms and Handouts
Hydrogel Products for None to Minimal Exudate/Drainage
Hydrogel Kit 30 Day Order HYD01
SILVER Hydrogel Kit 30 Day order HYD02
Collagen Products for Mild Exudate/Drainage
Collagen Particles Kit 30 Day Order CP01
Collagen Particles Kit 30 Day Order CP02
Collagen Particles Kit 30 Day Order CP03
Collagen Matrix Kit 30 Day Order CM01
Collagen Products for Moderate Exudate/Drainage
Collagen Particles Kit 30 Day Order CPS10
Collagen Particles Kit 30 Day Order CPS11
Collagen Particles Kit 30 Day Order CPS12
Collagen Matrix Products for Moderate Exudate/Drainage
Collagen Matrix Wound Kit 30 days CMS10
Collagen Matrix Wound Kit 30 days CMS11
Calcium Alginate +/- Ag Products for Moderate to Heavy Exudate/Drainage
Calcium Alginate Wound Kit CA01
Calcium Alginate Wound Kit CA02
Calcium Alginate Wound Kit CA03
Calcium Alginate Wound Kit CA04
SILVER Calcium Alginate Kit 30 Day Order SA01
SILVER Calcium Alginate Kit 30 Day Order SA02
SILVER Calcium Alginate Kit 30 Day Order SA03
SILVER Calcium Alginate Kit 30 Day Order SA04
Foam Kits Products for Moderate to Heavy Exudate/Drainage
Foam Non-Bordered 30 day Order FM01
Foam Non-Bordered 30 day Order FM02
Foam Non-Bordered 30 day Order FM03
Foam Non-Bordered 30 day Order FM04