The Local Coverage Determination requirements for documentation when ordering surgical/advanced wound care products for patients are:

 

  • Diagnosis & Location of wounds
  • Medicare & Insurances require debridement of wounds. (Guidelines)
  • Measurements (L x W x D) or documented as unstageable due to _______________.
  • Thickness: Medicare & Insurances only covers full thickness wounds. (wounds with granulation, fat-layer exposed, or subcutaneous tissue are considered full thickness)
  • Exudate/Drainage: None, Low, Moderate, Heavy, Copious (choose one)
  • Products: note primary & secondary dressings Local Coverage Determination for Products
  • Frequency of Change. Be specific (as needed, PRN, 2-3 times a week do not meet LCD requirements)

 

Medicare/Insurance requires each of these items for dressings to be covered.

Innovative Outcomes is here to help. We understand navigating the LCD requirements can be a lot, so please give us a call if we can help. A live person will answer the phone and our office is open Monday – Friday from 8:00 AM to 5:00 PM CST.

 

To refer a patient, simply send patient demographics, insurance, and wound information.

Phone:  866.714.7118          Fax:  866.217.9998          Email:  patientsfirst@ioutcomes.com