Wound/ulcer management professionals, hospital-owned outpatient wound/ulcer management provider-based departments (PBDs), and durable medical equipment (DME) suppliers are thankful for the research that manufacturers have performed to develop innovative technologies that help manage the increasing number of patients with hard-to-heal wounds and chronic ulcers. Some of these technologies include many categories of surgical dressings, negative-pressure wound therapy (DME and disposable), hyperbaric oxygen therapy, cellular and/or tissue-based products for skin wounds (outdated term "skin substitutes"), innovative diagnostic devices, platelet-rich plasma, and remote physiologic and therapeutic monitoring.
These wound/ulcer management stakeholders are also thankful for new/revised codes, positive coverage, and payment that makes it possible for professionals, PBDs, and DME suppliers to purchase and provide these innovative technologies. In recent years, the American Medical Association and the CMS have even provided enhanced coding, coverage, and payment for time spent assessing the underlying causes of wounds/ulcers.
Because such innovative technologies usually cost more, the payers often adjust their coverage policies and payment rates to control cost. Wound/ulcer management professionals, PBDs, and DME suppliers often find it difficult to keep up with all the coding, coverage, and payment changes. In fact, this author, who has spent 25+ years specializing in wound/ulcer management reimbursement strategy and education consultation, is at times overwhelmed with all the reimbursement changes that have occurred in the past few years and with the plethora of changes that are expected for 2023. For example, last month's Payment Strategies column addressed the frequently asked questions pertaining to the prolonged service codes that were created in 2021. Yes, it is now 2022, but it takes time for professionals to review new codes and incorporate the required documentation into their electronic health records. Now, just 1 month later, this author learned that the American Medical Association and CMS will be making changes to the prolonged service codes for 2023. As soon as all the prolonged service code changes are released, this author will share the information in this column. In addition, as always, this author will review the highlights of the 2023 reimbursement changes in future Payment Strategies columns.
In the meantime, you and your team should prepare for the 2023 reimbursement changes. To assist with this ever-increasing task, this author has created a checklist for you and all the members of your revenue cycle team (Table). Be sure that all the checklist items are assigned to the appropriate person(s) on your team and, most importantly, share all the new coding, coverage, and payment changes with all team members.