woundcare in hospital based practice

[Guest guest]

Can anyone shed some light on current billing/reimbursement for

woundcare done by PT in a hospital based practice? I have been

approached by our CNS who has been handling most of the outpatient

woundcare services. She is interested in pursuing a relationship in

which we provide much of the woundcare while she acts as an advisor

to assist in monitoring and making recommendations. She is under the

impression that we, too, are allowed to use E and M codes to bill for

woundcare services in PT.

I am under the impression that we cannot use E and M codes, and what

we have done is bill an initial PT evaluation if we have a PT plan of

care, goals, etc. After that, we can bill under the CPT codes

selective debridement and non-selective debridement/woundcare, both

of which are reimbursed as a single treatment unit, regardless of

time spent. With many of the patients falling under the non-

selective CPT code, our current fee schedule shows $0 reimbursement

from Medicare for that CPT code.

Are we missing an opportunity to bill differently? How are those of

you already doing hospital based, outpatient, woundcare providing and

billing for services?

Engesether, MPT

Coordinator Inpatient Rehab Services

North Country Regional Hospital

Bemidji, MN