Expert Insights On Dispensing Wound Care Products In The Office

Animesh Bhatia, DPM, CWS

Dispensing wound care products in the office can facilitate patient convenience, patient adherence and a better continuity of care that fosters improved outcomes. Accordingly, this author provides an overview of products that could be dispensed to patients in the office as well as insights on inventory management, coding and reimbursement.

The coming pandemic of diabetes and the monumental impact that it will have on the delivery of health services should be well known to any podiatrist. In addition to the epidemic of obesity, the aging population and the massive increase in patients with peripheral arterial disease (PAD), podiatrists are on the cusp of a tsunami of increasing lower extremity pathology.

   Given these factors, the most interdisciplinary impact will arguably occur with the management of wounds. For lower extremity experts, it is a true opportunity to cement a place in the world’s consciousness of the importance of the specialty. We need to ensure that we are ready to step up to the challenge, raise the bar of excellence and prove that every lower extremity wound, regardless of etiology, should have a podiatrist as an integral part of the team managing the wound.

   While the management of lower extremity wounds in high-risk populations may require involvement at every level of healthcare, such as hospitals, wound centers, nursing homes, homes and research, let us take a closer look at the office setting and how to sort through the jungle of wound care products, their basic categories and applications. In addition, it is important to understand proper documentation and protocols on dispensing these products in the office setting and billing for them.

   Why should a podiatrist dispense wound products from the office? The most important reason is that it will lead to better outcomes. This will subsequently lead to more referrals. When a DPM writes a prescription for dressings and sends the patient to a pharmacy or arranges for a home delivery company to mail the patient the products, there is much less likelihood of the patient following your instructions accurately. In addition, the care may not start immediately.

   When patients receive a large, intimidating box with a whole bunch of instructions, it is obviously no substitute for the doctor and staff giving them the dressings and demonstrating their use. This is the best method for facilitating better continuity of care.

Pertinent Pointers On Inventory Management

Take advantage of the fierce competition among distributors to negotiate better prices and better perks for wound care products. Ask for rapid delivery free of charge. That will allow you to keep a small inventory with minimal risk.

   Make sure you carry a few proven products in inventory. For example, a good way to start out would be to have one or two types of alginates, foams, hydrogels, hydrocolloids and collagens. These will be able to satisfy the initial needs for a wide variety of wounds. Although there is a myriad of choices of categories and dressings to delve into, this will provide a good foundation for any practice.

What You Should Know About Dressing Selection And Appropriate Coding

There are many factors to consider when evaluating the appropriateness of a specific dressing. Some of the factors influencing dressing choice are as follows:

• Anatomical site
• Amount of exudate
• Dead space
• Surrounding skin
• Caregiver ability
• Wound status
• Aggressive therapy versus palliative care
• Cost
• Reimbursement

   Calcium alginates (HCPCS codes A6196-A6199). These are made from brown seaweed and are extremely absorbent. The patient must have moderate to heavy drainage and your note must reflect this.

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