Wound Care Coding Guidelines In 2013

With immense coding and billing changes this year, wound care codes are no exception. In fact, there are considerable changes to CPT codes and coding guideline changes every year. Some of the important changes in wound care coding guidelines are as follows:

• Degree specific codes have been removed. So now all appropriately trained and licensed healthcare practitioners or in a more professional term “Qualified Healthcare Professional” can use all CPT codes. This means that there will be no PT codes or RN specific codes including surgical codes which are also not physician specific. Qualified healthcare professional can also use a code that describes a procedure appropriately specifying providers training and scope of practice.
• At present, the only thing that will be taken into consideration is that if the code describes adequately the procedure that was performed. So, the use of code 97597 used to describe debriding necrotic tissue from a wound will be taken into consideration which was previously only used as a PT code. Also the once superficial codes, 1104x have undergone revision and at present will be used to bill only for debridement of muscle, fascia and bone.
• There are some terminology changes as well which are as follows:

1. The term provider has been changed to “professionals”
2. The term practitioners has been revised to “individuals”
3. Physicians can now be termed as “qualified healthcare professionals” or “individuals”

Ensure Compliant Documentation through HIPAA Training To Survive HIPAA Audits

A number of trials have been conducted in a year for HIPAA Compliance Audit program and these audits were also a trial for the entities where they were conducted. Now plans are being made to revive this new HIPAA audit program in Fiscal Year 2014, after the US Department of Health and Human Services has evaluated it.

The set of rules used for the 2012 HIPAA audits by the HHS contractors have been published by USDHHS, making it easier to understand the exact way to prepare for the audits and implement HIPAA Compliance Training at AudioEducator. Audits are applicable for any health care covered entity as they need to understand the adequate information that they are required to provide and ways to avoid compliance related issues resulting in penalty.