Wound Care
Skin substitute reimbursement, debridement upcoding, and Medicare prepayment review for wound care providers.
Building a Wound Care Compliance Program
Chart auditing cadence, coding review, and remediation records are what turn a self-identified billing error into a correction ins…
Wound Care LCD Compliance Across MAC Jurisdictions
CMS nationalized the skin substitute payment rate for 2026, but coverage still depends on which Medicare Administrative Contractor…
Wound Care Kickback Exposure: Manufacturer Relationships
Rebates, consulting fees, and free skin substitute product tied to referral volume can trigger Anti-Kickback Statute and False Cla…
Wound Care in Skilled Nursing Facilities: Audit Exposure
SNF consolidated billing bundles most wound care into the Part A rate. Facility, practitioner, and Part B billing splits are drawi…
Venous Leg Ulcer Care and Compression-Therapy Documentation
Medicare pays for compression bandages only over a qualifying wound. The same chart entry backs the pump, the graft, and every cla…
Skin Substitute Distributor Arrangements and Enforcement
A $309 million DOJ settlement shows how distributor commissions and pricing spreads on skin substitutes become Anti-Kickback Statu…
Selective Versus Excisional Debridement Documentation
Selective and excisional debridement pay differently and require different proof. What the operative note must show, and why wound…
Selecting a Skin Substitute: Documenting Medical Necessity
How to document product selection, conservative care, and wound measurement so a skin substitute claim holds up under Medicare's 2…
Product Purchase Records in Skin Substitute Audits
UPIC and MAC auditors now compare skin substitute purchase records against billed units. A shortfall between the two is becoming t…