Wound Care
Skin substitute reimbursement, debridement upcoding, and Medicare prepayment review for wound care providers.
Mobile Wound Care Practices Under Federal Review
Travel-based wound care models are drawing federal scrutiny over place-of-service coding, patient selection, and visit documentati…
Negative Pressure Wound Therapy Billing Under Audit
How NPWT device documentation, duration-of-use limits, and DME overlap with professional wound care billing become audit findings.
Hyperbaric Oxygen Therapy Audits
CMS covers hyperbaric oxygen therapy for only fifteen conditions, and OIG audits found the majority of sampled claims failed to do…
Diabetic Foot Ulcer Documentation Requirements
Medicare's Local Coverage Determinations specify exact documentation for diabetic foot ulcer care: Wagner grading, vascular assess…
Debridement Frequency and Medical Necessity Challenges
How Medicare frequency checkpoints and documentation standards determine whether a repeat debridement claim survives audit review.
CTP Reimbursement Changes and What They Mean for 2027
CMS moved skin substitute reimbursement to a flat per-square-centimeter rate in 2026. A proposed 2027 rule would extend it to non-…
Debridement Depth Coding: 11042 Through 11047
CPT 11042-11047 pay on the deepest tissue removed, not the deepest visible. What documentation each depth tier needs, and how gaps…
Conservative Care Requirements Before Advanced Therapy
Medicare will not cover a skin substitute graft or hyperbaric oxygen therapy without proof that conservative wound care failed fir…
Cellular and Tissue-Based Product Waste Billing
CMS ended wastage billing for skin substitutes effective January 1, 2026, and UPIC audits already test whether billed graft sizes…