Demystify Wound Care Coding & Billing Challenges and Maximize Revenues

With a growing aging population in the US, wound care has significantly gained importance since a large portion suffer from ailments with the risk of acute and chronic wounds that require constant care. Not just the elderly, proper wound care plays an important role in the healing process in patients of all age groups. However, caring for patients with such wounds is a challenge, compounded by the ever-changing regulatory requirements and billing guidelines. This makes timely and accurate reimbursements difficult to obtain. Wound care billing companies can help overcome these challenges and ensure proper payment for wound care services rendered.

The challenge is that all types of wound care are not covered by insurance and the ones that are covered require a series of administrative activities like proper documentation with accurate detailing and also accurate coding. Before claim submission, providers must determine whether the wound treatment falls under medical necessity guidelines and whether it is covered by the patient’s insurance policy. This requires familiarity with the medical necessity guidelines, insurance coverage policies, and prior authorization requirements.