Wound care or chronic ulcer billing is challenging for healthcare providers. Approximately, 8.2million people suffer from wounds in daily life, and the total expense on patient care exceeds $30bilion yearly.
However, the providers have to follow a complete billing process and file a claim to get reimbursements against the services rendered. It involves documentation, coding, and claim submission.
This blog will explain how chronic ulcer billing services can help providers get timely reimbursements and improve patient care quality.
What are Chronic Ulcer Billing Services
Chronic ulcer billing is a process of making a claim against healthcare services and sending it to insurance companies for the pending amount. This is a multi-step process including patient insurance coverage verification, organizing documents, code assignment, and claim submission.
Healthcare providers remain busy with patients and spare a little time for billing issues. Consequently, they get overwhelmed with this lengthy process, commit mistakes, and lose practice revenue.
Outsourcing chronic ulcer billing helps provider to free up their time, focus on patients, and get faster payments without messing with billing complications.
Chronic Ulcer Billing Process
Chronic ulcer billing is a step-by-step process that a provider cannot handle alone. There is a need for proper resources and expertise to handle billing complexities. From verifying patient insurance to claim submission and denial management, every step should be handled carefully.
Juggling between billing and patientcare becomes overwhelming for the providers, resulting in administrative errors, workload, claim rejection, and revenue loss.
Verifying Insurance Coverage
Patient insurance verification is a crucial step in chronic ulcer billing. Ignoring it results in patient dissatisfaction, increased denials, and revenue loss due to out-of-network coverage or inactive patient insurance coverage policies.
Record Keeping
Wound care involves medicines and the use of numerous medical supplies. Therefore, a healthcare organization needs a coding expert to assign accurate codes to the services and equipment. A small mistake in code assignment results in losing thousands of dollars.
Claim Preparation
After carefully organizing the documents and assigning codes, the experts start preparing claims. Considering the payer regulations is important when filing the claims, as it ensures quicker reimbursements.
Denial Management
Healthcare experts are often busy with patients and pay less attention to tracking the denied claims. Ignoring these claims results in revenue leakage; efficient management can result in quick acceptance and faster payments.
Where Providers Struggle with Chronic Ulcer Billing
Apart from the entire billing process, healthcare experts struggle with code assignments. Wound care billing is complex, having multiple codes for every disease. Chronic ulcer coding includes different CPT and ICD codes.
Connecting CPT with wound care ICD Codes
- L97.411–L97.429: Chronic ulcer of right lower leg
- S91.301A: Open wound, right foot
- T81.89XA: Other complications of procedures
- S41.111A: Open wound, right upper arm
CPT wound care codes
- 97597 – Debridement of open wound (20 sq. cm or less)
- 97598 – Each additional 20 sq. cm
- 11042–11044 – Debridement of subcutaneous tissue, muscle, fascia, or bone
- 15271–15278 – Application of skin substitute grafts
Wound care codes for dressing change
- 97602: Non-selective debridement (includes dressing change)
- 29580–29581: Application of multi-layer compression dressings (leg or arm)
Having knowledge about such diverse coding is difficult for healthcare experts. Therefore, they require a professional coder to smoothly handle chronic ulcer coding.
How Chronic Ulcer Billing Services Offer Solution
Treating chronic diseases requires time and patience. Therefore, providers pay less attention to the billing matters and experience claim rejection, leading to revenue leakage. Chronic ulcer care services can resolve the matter.
These service providers bring in expert resources who leverage years of expertise and tech-powered solutions to handle chronic ulcer billing issues and boost practice revenue.
- A dedicated billing team: hiring a reliable chronic ulcer billing agency helps providers access a dedicated team for the billing complications and focus only on patient care.
- Smooth billing process: the billing experts do a comprehensive audit and eliminate the mistakes to strengthen the chronic ulcer billing process.
- Lower claim denials: outsourcing billing to specialized agencies also results in lower claim denials and faster claim acceptance, resulting in quick revenue.
- Faster revenue growth: the billing team runs regular checks on the process to ensure claims are getting accepted and providers are earning a stable
Handling the chronic ulcer billing process along with patient care seems impossible for a healthcare provider. Therefore, getting external assistance is the key to eliminating the workload, boosting operations, and generating faster revenue.
Best Practices to Handle Chronic Ulcer Billing Complications
Understanding about types of Wound Care
Wound care involves treating various types of wounds, including.
- pressure ulcers,
- venous stasis,
- diabetic foot ulcers
- cut or burn
Knowledge of these wounds is crucial for proper billing and coding. Healthcare organizations often outsource the billing department to spare time for healthcare. If you are a solo practitioner, you can manage the billing by understanding the types of wounds.
Stages of Wound Healing
Wound healing is a multi-step journey starting from hemostasis, followed by prefiltration and remodeling. The human body starts bleeding at the first stage and releases immune cells during inflammation to prevent infection.
The body forms new tissue in the prefiltration stage to heal/fill the wound. In the remodeling stage, the tissue is strengthened.
Learning about this process helps providers to accurately manage the document and assign codes to receive faster reimbursements against the services provided.
Diverse Treatment Modalities
Wound care comprises of different treatment modalities, including
- Debridement
- Dressing
- Topical agents
- Negative pressure wound therapy
Debridement includes the removal of dead tissues from the wound. Then, topical agents are applied to speed up the healing process. Negative pressure therapy aims to encourage wound suction for quick healing.
Knowing all this will help the provider to manage the billing without seeking assistance from the experts. However, when the healthcare business scales, providers need a separate resource to handle these problems.
Final thoughts
Chronic ulcer billing services refer to billing for wound care. Healthcare organizations often outsource their billing to focus on patient treatment and receive faster payments. These agencies efficiently handle billing from insurance verification to claim submission and denial management, ensuring quick reimbursements against the services.
If you are a single physician with limited resources, you can handle the billing by understanding wound care billing, stages of wound healing, and treatment modalities.
Struggling to manage your medical billing complications? Let Kansas Medical billing experts handle it for you while you focus on patient care and receive faster payments.
Frequently Asked Questions
What is chronic ulcer medical billing services?
Chronic ulcer also known as wound care billing services, involves hiring a reliable billing company to handle the billing and manage the revenue cycle.
What is the ICD code for chronic ulcer billing?
ICD code L98.499 is the code against non-pressure chronic skin ulcer.
What are the CPT codes for wound care?
CPT code for wound care is 99490
What are the benefits of chronic ulcer billing services?
- Personalized resources
- More time for patient care
- Smooth operations
- Fewer denials
- Quick revenue
Who can avail chronic ulcer billing services?
From a single practitioner to a large healthcare organization can avail the chronic ulcer billing services.
