Wound Care Coding- How To Approve?

By Author: Angela Martin
Total Articles: 205
Comment this article

Wound care seems to be quite easy but often it gets quite complicated. Below are some guidelines on wound care coding to provide some assistance to you?
Code all the documented conditions that coexist at the time of encounter and which require or affect the patient care management. But, do not code the conditions that no longer exist and were treated previously.

3. Injuries such as abrasions or contusions are not included in wound care coding when correlated with more severe injuries of the same site.
If a primary injury leads to damage to blood vessels or peripheral nerves, then the primary injury is sequenced first followed by the additional code(s) from categories 950-957 (Injury to spinal cord and nerves) and/or 900-904 (Injury to blood vessels).
If the primary injury is to the nerves or blood vessels, that injury must be reported first.

4. If the nurse is taking a verbal order, he/she is required to ask for specific diagnosis.
Confirm if the diagnosis is related or secondary to diabetes or any other condition as it can affect the code assignment.
A diagnosis which is coded ...
... from the MD order is acceptable.
A non-specific ICD-9-CM code or a code not adhering to the medical necessity for the treatment being provided can lead to claim denial.

Following are some helpful tips on proper wound care coding process.

Firstly, review the scheduling, registration, purchasing, and pharmacy, coding and billing processes.
Review the paperwork flow (from referral to claim submission and finally to revenue audit).
Make efforts to obtain wound care specific EMR that will serve both the outpatient department and the physicians.

For further information on wound care coding, wound care management and any other wound care related issue, sign up for an audio conference and stay informed.