Wound Care

“I am not sure when I should and can bill for an E/M when seeing patients for wound care. Is it reasonable to bill an E/M code if the patient returns for follow up for their ulcer and it is 100% healed? Occasionally hyperkeratotic tissue is present and sometimes I debride the callus to confirm the ulcer has healed. I always spend time on these visits educating the patient on ulcers and the diabetic foot. Would it be appropriate to code for an E/M at this visit since the vast majority of the time is spent counseling the patient prior to discharging them from care?”

“I often provide wound care for hospice patients and append the GW modifier. However, I recently read that it would be hard to defend this as the wound(s) and wound process is likely related to the patient being deconditioned and malnourished due to their hospice qualifying condition. I am looking for clarification regarding this, should I stop performing wound care services to hospice patients?”