March 1, 2014 | Net Health

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Practice Point: Wound Care Documentation, Compliance, and Revenue Checklist


In the previous column, 2014 OPPS Final Rule Drives Critical Documentation Elements, we discussed the release of the Centers for Medicare & Medicaid Services (CMS) 2014 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates. We also began to review the essential documentation elements necessary to support the work performed in the wound care department, focusing our efforts on medical necessity. The information provided can easily be positioned as a checklist for your team to follow.

Many checklists can be created and used as written guides to help your team meet key steps in compliance. In wound care, clinical and operational rules help maintain compliance with standards, and checklists can provide an audit tool to ensure that requirements have been followed. Using a clinical checklist can help to better organize the clinician’s time.

Given the new payment parameters within 2014 OPPS Final Rule, the clinician’s checklist might look like this:
Work with your coding and billing department to educate your team on the Final Rule and payment changes (Medicare and non-Medicare payers).

  • Review your local coverage determination for updated changes.
  • Update your Charge Description Master to reflect the new code changes.
  • Review and update your Policies and Procedures to reflect stated changes.
  • Develop a Transition Memorandum to denote the change in coding and billing practices as of January 1, 2014.

Another initiative followed closely at this time is the progression of Meaningful Use…

Read the rest of the article at Advances in Skin & Wound Care.

An excerpt from an article originally published in Advances in Skin & Wound Care, written by Cathy Thomas Hess, BSN, RN, CWOCN, VP and Chief Clinical Officer at Net Health

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