Generate More Income For Your Practice Reimbursable by Medicare Reimbursable by Most Private Insurance Use the Provided Coding

GENERATE MORE INCOME FOR YOUR PRACTICE

  1. MD Buying Group has created home Wound Care Kits which are reimbursable by Medicare and most private insurances.
  2. Provide the 30 day kits to your patients for use the day after debridement. Bill using the provided coding.
  3. Types of Kits:
  • a) 2×2 hydrogel impregnated
  • b) 4×4 hydrogel impregnated
  • c) 2×2 calcium alginate
  • d) 4×4 calcium alginate
  • e) 2×2 collagen dressing
  • 4. Kits also include a 30 day supply of bordered gauze (also reimbursable) and an 8 oz. wound wash.

 

Scroll down to see insurance billing tips

  • KITComponent Product
  • Daily Reimbursement
  • 30-Day Reimbursement
  • Suggested HCPCS Codes

When completing claim form/electronic claims submission:

  •  Place of Service is “12” (Patient Home)
  •  Quantity is 30 for each dressing. In the column or field labeled Days/Units/Quantity, enter 30 FOR EACH OF THE DRESSINGS BILLED. This is because you are billing for a 1 month supply of products.
  •  Use the correct CPT billing codes listed above and modifier A1 (if billing 1 wound), A2 (if billing 2 wounds), A3 (if billing 3 wounds), etc. (see above)
    o If billing 2 wounds (modifier A2) the number of Days/Units/Quantity billed should be 60.
    o If billing 3 wounds (modifier A3) the number of Days/Units/Quantity billed should be 90.
    ·
  • There is no reimbursement for Wound Cleanser
  •  IMPORTANT: If you are billing for wound debridement in the office, you cannot bill the wound care package the same day as the debridement. The thirty day billing period for the Wound Care Package should start the day after the debridement.

Medicare Fee Schedule 2023 Q2

A6231

$6.24

A6196

$9.79

A6021

$27.96

A6219

$1.27

A6220

$3.45

Hydrogel Saturated 2×2 Gauze Wound Care Kits – HCPCS code: A6231 and A6219

  • 2X2 Hydrogel Impregnated Gauze (30)
    Use Code A6231
    Bill: $6.24 each x 30 days = $187.20
  • 4X4 Bordered Gauze (30)
    Use Code A6219
    Bill: $1.27 each x 30 days = $38.10
  • 2oz Spray Wound Cleanser
  • Cost of Kit = $83.94 Now $33.00

Total 30-Day Reimbursement = $225.30

Hydrogel Saturated 4×4 Gauze Wound Care Kit

  • 4X4 Hydrogel Impregnated Gauze (30)
    Use Code A6231
    Bill $6.24 each x 30 days = $187.20
  • 6X6 Bordered Gauze (30)
    Use Code A6220
    Bill $3.45 each x 30 days = $103.50
  • 2oz Spray Wound Cleanser
  • Cost of Kit = $108.15 Now $38.00

Total 30-Day Reimbursement = $290.70

2×2 Wound Care Kit with Calcium Alginate

  • 2X2 Calcium Alginate Dressing  (30)
    Use Code A6196
    Bill: $9.79 each x 30 days = $293.70
  • 4X4 Bordered Gauze (30)
    Use Code 6219
    Bill: $1.27 each x 30 days = $38.10
  • 2oz Spray Wound Cleanser
  • Cost of Kit = $124.11 Now $39.00

Total 30-Day Reimbursement = $331.80

4×4 Wound Care Kit with Calcium Alginate

  • 4×4 Calcium Alginate Dressing (30)
    Use Code A6196
    Bill: $9.79 each x 30 days = $293.70
  • 6X6 Bordered Gauze (30)
    Use Code A6220
    Bill: $3.45 each x 30 days = $103.50
  • 2oz Spray Wound Cleanser
  • Cost of Kit = $149.35

Total 30-Day Reimbursement = $397.20

2×2 Wound Care Kit with Collagen Dressing

  • 2X2 Collagen Dressing (30)
    Use Code A6021
    Bill: $27.96 each x 30 days = $838.80
  • 4X4 Bordered Gauze (30)
    Use Code 6219
    Bill: $1.27 each x 30 days = $38.10
  • 2oz Spray Wound Cleanser
  • Cost of Kit = $328.57 Now $120.00

Total 30-Day Reimbursement = $876.90