medicare wound care question

[melissahunter2]

Hello all. I am new to HH and I am still so confused about medicare. Who is responsible for paying for wound care supplies? For exampe- anti-fungal cream and powder, abdominal pads???

[annaedRN, RN]

Medicare reimburses the agency one lump sum ( determined by the MO questions on the OASIS) for the 60 day episode. That reimbursement is to include all visits from all disciplines as well as supplies. It varies with insurances other than Medicare.

[melissahunter2]

That was my understanding. Today the company had the client purchase the cream and the powder since it was otc???

[annaedRN, RN]

If it is a prescription cream or something OTC like neosporin then the patient picks it up. We do keep things like aloe vesta cream, calmoseptine and anti-fungal powder in house to bring out. I guess that differs from agency to agency.

[BlueRidgeHomeRN]

that was my understanding. today the company had the client purchase the cream and the powder since it was otc???

it's also a good reason to code the admission oasis correctly to get paid for these supplies!!

[caliotter3]

The agencies that I have worked for did not supply anything. The patient is responsible for anything that the insurance company does not reimburse. This can be quite offputting when you need something and it isn't there and the patient says they can't afford to buy it themselves.

[homehealth43130]

Here is the link to the consolidated billing list

http://www.cms.hhs.gov/HomeHealthPPS/03_coding&billing.asp

everything on the list is consolidated into the PPS rate.

[melissahunter2]

Thank you for all of your responses.