Combat Outpatient Wound Care Coding and Documentation Challenges in 2019  - On-Demand

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Combat Outpatient Wound Care Coding and Documentation Challenges in 2019 - On-Demand

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Combat Outpatient Wound Care Coding and Documentation Challenges in 2019 - On-Demand

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Available ON-DEMAND

Presented on:
Tuesday, March 12, 2019 

Presented by:
Gloria Miller, CPC, CPMA, CPPM

Level of Program:

Wound care coding and billing carries unique challenges compared to other specialties, as wound size, depth, and severity must be properly documented to report the most accurate ICD-10-CM and CPT® codes. With fiscal year 2019’s new ICD-10-CM codes for obstetrical wound infections and post-procedural infections, coders’ jobs have become even more difficult. Wound care clinics are also facing increased scrutiny from Medicare auditors and the Office of Inspector General regarding the reporting of debridement procedures.

During this 90-minute webinar, Gloria Miller, CPC, CPMA, CPPM, will review the latest ICD-10-CM and CPT codes and coding guidelines applicable to wound care services. Miller will discuss best practices for wound care documentation, coding, and billing, as well as efforts by CMS to identify and correct for improper payments. She will also explain how to find available Medically Unlikely Edits (MUE) for certain procedures and provide in-depth answers to frequently asked questions.

At the conclusion of this program, participants will be able to:

  • Locate appropriate diagnosis codes for wound care local coverage determinations (LCD), as well as available MUEs for procedures
  • Prevent reimbursement issues by understanding MUEs and documentation requirements for surgical debridement
  • Protect against Zone Program Integrity Contractor investigations and audits
  • Properly apply -X{EPSU} modifiers
  • Describe LCD coverage limitations and pricing for high- and low-cost skin substitutes


  • Medical necessity for wound care procedures
    • Documentation necessary to meet medical necessity
    • Finding diagnosis codes related to medical necessity
  • Fiscal year 2019 ICD-10-CM wound care codes
    • New codes for obstetrical wound infections, post-procedural infections
    • Documentation for non-pressure-related ulcers
  • Reimbursement issues surrounding CPT coding for surgical debridement
    • Documentation required for all three debridement CPT code ranges
    • Providers who can administer procedural supervision 
  • CMS efforts to ensure compliant coding and billing practices
    • Reviewing Medicare Targeted Probe & Educate process for identifying billing errors
    • Preparing for Zone Program Integrity Contractor audits and subsequent appeal process
    • Identifying gaps in documentation to reduce audit risk
  • MUEs
    • Procedures likely to run against MUEs
    • Where to find them
  • In-depth answers to frequently asked questions
    • When to use modifier -59 vs. -X{EPSU} modifiers
    • How to charge for cellular tissue-based products

Who Should Listen?

  • HIM managers and staff
  • Outpatient coding managers and staff
  • Wound care staff
  • Compliance staff
  • Chargemaster coordinators
  • Finance staff
  • Provider-based clinic billers and coders
  • Revenue integrity staff

Meet the Speaker

Gloria Miller

Gloria Miller, CPC, CPMA, CPPM,
has worked as the vice president of reimbursement services at Comprehensive Healthcare Solutions, Inc. in Seattle, where she assisted hospitals with correct documenting, coding, and billing for wound care and hyperbaric oxygen services. She has many years of varied experience in healthcare reimbursement, including durable medical equipment, hospital billing, skilled nursing facility billing, and infusion pharmacy billing.



Continuing Education

This program has the prior approval of AAPC for 1.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Ability to claim credits for this webinar expires on: 03/11/2020

(Live + On-Demand) This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Ability to claim credits for this webcast expires on: 03/11/2020


Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email if you have questions.