Wound Care Billing & Coding Guidelines
Find the billing and coding guidelines you need, including access to ICD-10 information, documentation tools, evaluation and management, CMS HBO National Coverage Determination (NCD), modifiers and more.
Evaluation and Management (E&M)
CMS’ Evaluation and Management (E&M) Services Guide
Review CMS’ E&M guidelines when selecting an E&M code for billing purposes that accurately represents the services provided.
CMS’ 1995 Evaluation and Management Documentation Guidelines
Healogics Specialty Physicians (HSP) uses CMS’ 1995 guidelines to determine the appropriate patient E&M level. Reference these guidelines for accurate E&M coding.
Evaluation and Management (E&M) Tools by CPT Code
Required Components for Initial and Subsequent Hospital Care E&M Services (CPT codes 99221-99223 and 99231-99233)
This tool summarizes the required components to properly document and select the patient’s correct E&M level CPT code 99221-99223 and 99231-99233.
Required Components for New and Established Patient E&M Services (CPT code 99201-99205 and 99211-99215)
This guide summarizes the requires components to properly document and select the patient’s correct E&M level CPT code 99201-99205 and 99211-99215.
Coverage Policies & Other Tools
CMS’ National Coverage Determination (NCD) for Hyperbaric Oxygen Therapy Section 20.29
CMS’ HBO NCD provides the list of the 15 covered HBO indications. The NCD also includes additional coverage guidance for the Diabetic Wounds of the Lower Extremity (DWLE) indication.
Modifier Reference Sheet
The Modifier Reference Sheet will allow providers to accurately append modifier(s) when necessary to provide the required information to the payer regarding the services or procedures rendered to a patient during their encounter to ensure proper billing and payment.