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Need help with anyone dealing with wound care to help

  1. Default Need help with anyone dealing with wound care to help
    Medical Coding Books
    Our NP is wound care certified and does wound care/debridements for our hospice patients and their hospice benefit covers these services. However, we also have a palliative care patients (they fall under Part B services since they are not enrolled in hospice) that she is starting to do these services for.
    Anyway, there is a new wound care product, Medihoney, that she has found particularly useful in cancer wound healing/treatment. This product comes as a dressing embedded with a honey compound that is FDA approved as of October 2007 for treatment of diabetic ulcers and venous stasis ulcers.

    They are still running open studies, but am wondering in order to bill Medicare, would I need to do as preapproval or would it be best since it is still so new to try to enroll in the open study since they do not document use in the treatment of cancer wounds on their website. The particular patient that we have tried it with has fungating breast cancer and there was a day/night difference in her wounds and we have another one we would like to try it one. We received samples that were sufficeint enough to treat the first patient, but from now on we would need to either bill the patient and/or insurance and I would rather not have to burden these families with the cost!


  2. #2
    NCF Gainesville
    Unfortunately, I don't believe Medicare will give "preapprovals" for services. Also, if it is a product that is considered experimental still, or if you would have to use an "unlisted procedure" CPT code, there probably isn't much hope of getting it paid for. Very sad because many times some of the best treatments are too expensive. I was very interested to read about this though, because one of the specialists I code for does wound care...I think I will mention it to her.

    Best of luck,
    Jeni Smith, CPC, CPMA

  3. Default
    Thank you and Good Luck on your exam, I'm sure you'll do great!

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