Wound care billing has more ways to go wrong than almost any other specialty. Our team gets the details right so your clinicians get paid for every procedure they perform.
Wound care coding is procedure-heavy, documentation-dependent, and audited closely by payers. General billing staff consistently underbill or miscode these claims.
Selective vs. non-selective, surgical vs. mechanical, each debridement type carries its own code. Miscoding a single session costs the practice heavily.
Payers require wound measurements in centimeters with length, width, and depth recorded at the time of service. Missing or inconsistent measurements are the primary reason wound care claims are downgraded or denied on review.
HBO therapy requires diagnosis-specific pre-auth with strict medical necessity criteria. Without proper documentation and proactive authorization management, approvals and treatments get delayed.
Skin substitute products are billed by the square centimeter, and payers have wildly different coverage policies for each product. Without a team, you're either leaving money uncollected or filing claims that will never pay.
We assign wound care billers who understand the clinical workflow, know the payer policies by product and procedure, and catch errors before a claim leaves the system.
Each debridement and wound management claim is reviewed against the clinical note to confirm the code matches the documented depth, method, and wound size before submission.
We cross-reference the specific product billed against the applicable payer's coverage policy before the claim goes out, including application frequency limits for skin substitutes.
We build the claim package for wound therapy equipment, including the physician order, treatment failure history, and wound classification required to clear payer review the first time.
When a wound care claim is denied, our team identifies the exact reason, corrects it, and resubmits within two business days rather than letting it age in an AR queue.
We run a no-cost audit of your current wound care billing and show you exactly what is being miscoded, denied, or left on the table before you make any decision.