Home Health & Hospice Week

Prepare for the big shift, expert advises.

You might want to ring in the new year with a review of new disposable negative pressure wound therapy device billing procedures for your relevant staff.

Why? “Effective on January 1, 2024, [for] period of care claims with ‘Through’ dates on or after this date, the billing and separate payment of an applicable disposable negative pressure wound therapy (NPWT) device shall be billed/paid on the period of care claim, Type of Bill (TOB) 032x,” HHH Medicare Administrative Contractor Palmetto GBA explains in a new article on its website. MACs “will also apply deductible and coinsurance amounts to the payments,” Palmetto highlights.

The MAC clarifies that for the service date, “any date within the billing period is acceptable. The HHA may enter the date the device was applied or if there were more than one device applied during the period, the HHA may enter the date the first date the device was applied.”

Remember: “The nursing visits will be considered just another nursing visit reported on your claim and will be compensated under the HIPPS code payment,” explains reimbursement expert Melinda Gaboury with Healthcare Provider Solutions in Nashville, Tenn. “The device will be itemized on the claim as a separate line item and it will be paid separately in addition to your HIPPS code amount,” Gaboury elaborates in her Monday Minute with Melinda vlog.

“This represents a significant shift for those who have been correctly billing the Disposable Negative Pressure Wound Therapy (NPWT) devices,” Gaboury stresses. “It’s crucial that this information reaches your billing department.”

Watch out: “Don’t submit claims with a date of service on or after January 1, 2024, for an applicable disposable NPWT device on TOB 034x,” as was previously permitted, Palmetto instructs. “Medicare will return claims on TOB 034x containing CPT codes 97607 or 97608 for a date of service on or after January 1, 2024,” the MAC says.

Note: Finding coding and other billing details at www.palmettogba.com/palmetto/jmhhh.nsf/DID/QDPLCEREFM.