Wound care and Home Health Care

kathymoon

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Lansing, Michigan
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I bill for a Wound Care Clinic and I am getting rejections from Medicare for my 97597 because it is "included in payment for another service." I finally figured out that the patient is on a Home Health Care plan. Does anyone know if I can appeal and get paid for our wound care visits as we are not related to the Home Health. Or am I just out of luck. Thanks for your advice.
 

Kberg1983

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Hi there-

The wound care clinic would have to have an agreement in place with the Home Health Agency ahead of time in order for your provider to be reimbursed. If you had agreement in place to provide those services during the Home Health Agency's episode, they would reimburse you directly for providing those services.
 
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