ADVANCED WOUND CARE

TREATMENT FOR ACUTE AND CHRONIC WOUND CLOSURE

Advanced Wound Care made easy.

We can treat your patients at your location, our specialty clinic, or we can visit them in the convenience of their own home! From initial assessments, to treatments and billing, we work hand in hand with your practice to assist your patients that require advanced wound care.

Before sending your patients to a hospital for Advanced Wound Care, consider us as your high-touch specialist to assist your practice.

Amniotic membrane grafts and other skin substitutes are constantly improving. It takes dedicated attention to offer the most effective products on the market. We partner with experts in this niche that provide us with the highest rated and newest innovations in wound care treatment industry.

Help your patients get the most advanced treatment for their wounds such as:

  • Diabetic Ulcers
  • Venous stasis ulcers
  • Decubitus / Pressure Ulcers
  • Surgical incisions
  • Burns
  • Other dermal defects and wounds

When Standard Care is Not Enough.

Why use our Advanced Wound Care?

  • Covered by most insurance
  • Not captive to one supplier
  • Partnered with Home Health
  • Many Advanced Wound Care product company contracts
  • All tissues are recovered and processed by a U.S. FDA registered and AATB accredited tissue bank

Using of Amniotic Membrane Derivatives for the Treatment of Chronic Wounds Journal Review

 

Physician's Guide to Reimbursement Issues

 

Wound Care – Medical Necessity / Insurance Verification / Ordering Process

Clinic / provider needs to have 1 conservative visit each week for 4 weeks with patient before Wound Care skin product – Membrane Wrap or Dermacyte can be utilized.

A wound has to be considered a non-healing wound for Medicare to reimburse for wound care skin products.

A wound is considered non-healing if the closer of the wound has not reduced by 50% at the 4th conservative visit.

Example: A wound at the first conservative visit is 2cm x 2cm –

At the 4th visit the wound measures 1.7cm x 1.7cm then wound is defined as non -healing and IS appropriate for skin product as per Medicare guidelines.

Example: A wound at the first conservative visit is 2cm x 2cm –

At the 4th visit the wound measures 1cm x 1cm then wound is defined as healing and is NOT appropriate for skin product as per Medicare guidelines.

You can use the product on the conservative 4th visit if the wound has not been reduced by 50% since the first conservative visit.

If there are thoughts that the wound might heal up to 50% after the 4th visit, then utilizing wound care product should commence at the 5th visit if appropriate.

Documentation Requirements –

  • Measurement of Wound
  • Picture of wound
  • Chart notes of care given for conservative visit
  • If debridement occurred as part of the conservative visit, picture and measurements should be taken before and after debridement.

This documentation for these 4 conservative visits should be sent to Greystone via clinic secure

Dropbox, secure email or fax.

Sample chart note for after the 4th conservative visit that shows Medical Necessity –

  • The wound at wk 1 was 2x2 and with conservative wound care, debridement, dressing changes, no infection and proper blood flow the wound size is 1.5x1 at week 4. This wound is a non-healing wound and we are going to utilize a human amniotic tissue to help speed the healing process.

Best Practices –

Benefit verification / pre auth should be submitted after the 2nd conservative visit so provider has it at the ready to order product if / when appropriate.

  • Benefit Verification / Pre Auth form for specific product provided.

Currently this program is only for Traditional Medicare and benefit verification / pre auth is finalized and returned within 24 hour.

Ordering of product can be done only after benefit verification / pre auth has been submitted and approved.

Best practice is to order the product after the 3rd or 4th visit – whenever it has been determined that the wound will not be self-healing.

  • Ordering Form for specific product provided.

After ordering, the delivery of the product is overnight.

  • For next day delivery for Membrane Wrap – ordering must be done by 6:30 EST prior to receive the next day.
  • For next day delivery for Dermacyte – ordering must be done by 3:30 EST prior to receive the next day.

Greystone will take on the billing once the utilization of the wound care skin product starts.

If Clinic is not an existing Greystone client, Greystone will obtain onboarding information and work with our clearing house for EDI to bill Medicare for Membrane Wrap or Dermacyte.