5 Common Errors We See in Wound Care Medical Billing and Coding

As a wound care provider, you are acutely aware that not every wound heals quickly. For some patients, these chronic wounds can last weeks and months with no signs of improvement and lead to life-altering complications. Needless to say, early intervention and treatment are critical to proper healing, and that’s where you can help. But while you are amazing at the services you provide, errors on the backend with wound care medical billing and coding keep you from getting paid.

With 6.5 million patients annually seeking help for their unique wound care needs, it has become more crucial than ever for wound care providers such as yourself to make sure medical billing and coding processes are on point. 

If this conversation overwhelms you, don’t fret. 

Many common errors we see in wound care medical billing and coding are easy to resolve when you know what to look for and, more importantly, have the right coders in your corner.

5 Common Wound Care Medical Billing Errors

  • Patient eligibility — Patients often cancel their medical insurance or switch to another provider without telling their wound care provider. Next thing you know, you’re submitting a claim to the wrong carrier. The easy fix to this is communicating to your clients before service that up-to-date policy information is critical to a fast claims process.
  • Invalid diagnosis codes — There is no need to bury your head in the sand from embarrassment. It is difficult for any provider to keep up with the litany of wound care medical billing codes, all of which are specific to related diagnoses and treatment options. For example, if a patient comes in with a pressure ulcer on their ankle, it is up to the provider to specify if the issue is with the right or left ankle, how deep the wound is, and the location. There are unique codes for all of that.
  • Incorrect patient address — It’s highly unlikely that a patient will provide an incorrect address, but what does happen to many wound care providers is that a patient’s address is formatted incorrectly. Perhaps the zip code is four digits instead of five, or the zip code and the state do not match. Accuracy is paramount!
  • Place of service — It is imperative to indicate where a patient was seen (hospital, nursing home, clinic, doctor’s office). Believe it or not, each has its own medical billing code. When that code changes, so does the charge code.
  • Diagnosis and treatment don’t match — Medicare uses Local Coverage Determination (LCD) guidelines for their codes to ensure that the diagnosis a patient receives matches up with the pre-approved treatment method for that diagnosis. If these codes do not match, it is very likely that a claim will be denied. 

You Shouldn’t Have to Go in Circles With Your Medical Billing

Getting paid for the services you provide is paramount to the long-term success of your medical practice. But you also need to deliver superior services to your patients, and you can’t do that when you’re stuck in an endless loop of chasing down unpaid bills, deciphering uncomfortable and confusing systems, and sitting on hold with insurance companies. This can leave you in a position where you constantly leave money on the table, and the patient experience suffers immensely.

The wound care medical billing and coding process should be smooth, efficient, and something you don’t have to tackle alone. TAT Billing Services is an extension of your practice. We have spent over two decades helping doctor’s offices near and far get paid. We understand the value this service brings to you and your patients — all that’s left is to give us a call.

Medical Billing That Turns Your Accounts Receivable Into Cash

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