Debridement Reminders Issued by OIG and Payors
October 31, 2007 | Leave a Comment
Keeping Abreast of Recent Developments
KATHLEEN D. SCHAUM, MS
The Office of Inspector General (OIG) Work Plans for the past few years include a study to determine the extent to which Medical Part B surgical debridement services met Medicare program requirements. The findings from the May 2007 OIG Report, Medicare Payments for Surgical Debridement Services in 2004 (available at: http//:oig.hhs.gov/oei/reports/oei/02-05-00390.pdf) offer several important insights.
In 2004, 64% of surgical debridement services did not meet Medicare program requirements, resulting in approximately $64 million in improper payments. Of these, 39% were miscoded, 29% had insufficient documentation, and 1% were deemed medically unnecessary (overlapping errors = 5%). In addition, most carriers had local coverage determinations (LCDs) and edits in place but conducted limited medical review of surgical debridement services.
Top 10 Concerns - Challenges to consider as you’re getting started
June 18, 2007 | Leave a Comment
Several times a week, wound care professionals call with questions about their wound clinics. Following are the top 10 questions that were asked in 2006 — common concerns among wound care centers. We present these questions as reassurance: if you have these dilemmas, you are not alone.
