* Qualifying Wounds
If wound is caused by, or treated by, a surgical procedure or requires debridement. This includes incisions that have dehisced, incisions that are allowed to heal by secondary intention, wounds being debrided or that have been debrided by any means (see below), burns treated with skin grafting and catheter entry points (except for infusion pumps) where the catheter is inserted into a blood vessel.
Debridement Criteria
Must be performed by a physician or other health care professional as permitted under state law. Any type of debridement qualifies; surgical, mechanical, chemical, and autolytic.
Compression Stocking
Stockings is covered as long as the patient has an opened wound
Non Qualifying Wounds
A skin condition treated with topical medication, cutaneous fistula not caused by/treated by surgery, healed wound (dressings to prevent friction or shear), catheter entry point if tube is for an infusion pump, first degree burn, skin tear, abrasion, venipuncture or arterial puncture site (e.g. blood sample) other than the site of an indwelling catheter or needle and stage 1 pressure ulcets.
Incident to Professional Service
Dressings applied as part of a professional service that is billed to Medicare are considered incident to the professional service and not separately payable. |
