Advanced Wound Care Market to Reach USD 14.89 Billion by 2026

Proper wound care is crucial to speed up the healing process and prevent any infection or complications. Impaired or delayed healing of the wound in chronic diseases as well as after surgical procedures poses serious threat to patients and puts them at the risk of infection, amputation and death. Along with providing wound treatment, podiatrists also prescribe wound care supplies for patients. Electronic wound care programs help to streamline the wound-care prescription process for podiatry practices and thus enhance patient care and satisfaction.

According to the market report from Reports and Data, the Advanced Wound Care Market is predicted to grow from USD 10.34 billion in 2018 to USD 14.89 billion by 2026, at a CAGR of 4.5% during the forecast period.

Key factors that boost this market growth are –

  • Increasing incidence of diabetes
  • Increasing geriatric population
  • Increasing wound ulcer prevalence
  • Advancing technology in advanced wound care products
  • Increased funding for wound care research
  • Rise in awareness programs on wound management
  • Rising geriatric population base at high risk of chronic wounds

The report also predicts that the existing and rising cost burden of chronic wounds will drive investment in advanced wound care technology and this will have a significant positive impact on the growth of the industry. However, high costs of advanced wound care products will hinder industry growth in the future.

The report has segmented the market on the basis of product type, wound type, end user and regional analysis. Wound care product type includes moist wound dressings (foam, hydrocolloid, film, alginate, hydrogel, collagen), wound therapy devices (pressure relief devices, negative pressure wound therapy systems, hyperbaric oxygen equipment, electrical stimulation devices, other wound therapy devices), active wound care (artificial skin and substitutes, autografts, topical agents).

Wound type includes surgical wounds, ulcers (pressure ulcers, diabetic foot ulcers, and venous ulcers), burns, traumatic wounds and other wounds. End users of this market are hospitals and clinics, home care settings and others. Region wise, the market is divided into North America (US), Europe (France, UK), Asia Pacific (China, India, Japan), Latin America (Brazil), the Middle East & Africa.

The major players in the market are Smith & Nephew (UK), Mölnlycke Health Care (Sweden), B. Braun (Germany), ConvaTec Group (UK), Coloplast (Denmark), Integra LifeSciences (US), 3M (US), Cardinal Health (US), Acelity L.P. (US), Medtronic (Ireland), Paul HARTMANN (Germany), Medline Industries (US), Advanced Medical Solutions Group (UK), BSN medical GmbH (Germany), MiMedx Group, Inc. (UK) and others.

Tips for Avoiding Podiatry Coding Mistakes

With detailed and specific codes, podiatry coding is a specialized process. Any mistake in selecting codes can lead to claim denials and thus reimbursement issues. Podiatry practices must also be up to date with the rapid changes in the coding standards or they may have to face decreased revenue.

Here are some key tips to prevent podiatry coding mistakes.

Choose relevant CPT and ICD-10 codes

Diagnosis as well as procedure coding for podiatry requires coders to undergo specific training in foot care and what’s required to document and prove medical necessity, as well as local and national coverage determinations.

Coders must be careful enough to clearly list and align at-risk conditions and painful conditions with the appropriate ICD-10 codes on the claim form. Practices should make sure to implement changing coding standards. ICD-11 transition is the next big change to happen. This code set was adopted by the World Health Assembly on May 25, 2019 and will go into effect on January 1, 2022. This 11th Revision of ICD is expected to revolutionize the way conditions are classified and coded in the clinical setting.

Billing for a lower level code or down coding to decrease the odds of being audited is also a mistake.

Correct use of modifiers

Using appropriate modifiers will allow all podiatry procedures including bunionectomy procedure to get properly paid. Coders are recommended to check the Correct Coding Initiative (CCI) edits, available at the Centers for Medicare and Medicaid Services (CMS) website or in a podiatry-focused resource such as the American Podiatric Medical Association (APMA) Coding Resource Center.

Selecting the wrong modifier will result in the claim being denied.

  • There will be confusion on whether to use a RT or LT modifier compared to the -50 modifier when performing bilateral services. NCCI edits help to determine whether that specific CPT code requires a single line billed with the -50 modifier or whether you need to bill two separate lines with the RT and LT modifier.
  • T codes should be used to separate surgery performed on multiple toes. If you only operate on a single toe, then there is no need to use a T modifier. Do not use a TA modifier to report a bunion surgery.
  • Specific evaluation and management (E/M) modifiers such as -24, -25 and -57 may create confusion as well. Use these modifiers only with E/M services. The carrier will automatically deny your claim, if it is used for any other service such as a diagnostic study or procedure.
    • The -25 modifier is often used incorrectly. This modifier must be used when the E/M service is “significant and separately identifiable” from the procedure a podiatrist is performing on the same day. Do not use this modifier if the treatment wasn’t medically necessary.

Focus on proper unbundling of services

Some services are bundled together under one code which shows that the podiatrist has performed one service as the result of doing another. Unbundling or fragmentation is the billing of multiple procedure codes for a group of procedures normally covered by a single, comprehensive CPT code. There are certain cases where healthcare providers will intentionally manipulate coding to maximize payment. This will be considered as Medicare fraud.

Unbundling may also occur if the coder misunderstands the proper coding process. Updated quarterly, NCCI is designed to ensure that physicians do not inappropriately unbundle CPT codes.

Durable Medical Equipment (DME) Documentation

The proper place of service (POS) must be submitted correctly on the claim form to ensure accurate reimbursement. The HCPCS codes used must be verified with the DME carrier and explanation of various options along with the financial implications for obtaining DME must be provided to patients.

In case of any claim denial, podiatry practices must carefully read the explanation of benefits, which will provide insight about why the claim was denied and thus can get the basis for an appeal. Appeal letter should also address the specific question the carrier has mentioned.

Podiatry practices should have a clear idea on what procedures are covered before providing treatments. For instance, while standard toe nail clipping is not covered by Medicare, nail debridement is covered. Wound care insurance verification is critical to verify patients’ insurance benefits before services are provided, which prevents non-payments that can impact your bottom line.

Reporting Wart Removal/ Destruction

Warts are local growths in the skin caused by human papillomavirus (HPV) infection. It appears as small lumps on the skin of the hands and feet. Different types of warts are – flat, genital, tuberculosis and plantar warts. Left untreated, warts can spread to other parts of the foot or even to the hands or other areas of the body. During the clinical assessment of the lesion, podiatrist will examine the wart carefully to determine that it is not a corn or a callus. Often the wart will be squeezed from side to side. The hard skin layer around it may also be trimmed to examine the wart further. Podiatry coding solutions are available to help podiatrists report wart treatments in their medical claims.

Plantar warts or foot warts are found on the sole (plantar surface) of the foot, while flat warts may arise on the face, legs and other parts of the body, often in large numbers. Plantar warts can be solitary or mosaic. While solitary wart is a single one which often increases in size and may eventually multiply forming additional “satellite” warts, mosaic warts are a cluster of several small warts that grow closely together in one area and are more difficult to treat than solitary warts.

Diagnosis and Treatment of Warts

Clinical documentation of warts includes describing the lesions including color and any secondary changes, and checking the patient’s overall health. Depending on the size, type and location of the wart, the right treatment method will be chosen.

Treatment options include

  • Applying salicylic acid solution
  • Cryotherapy
  • Surgical excision
  • Electrosurgery
  • Laser treatment
  • Prescription creams for genital warts

Medicare Coverage for Warts

Medicare benefits will cover outpatient surgical procedures for warts, only if they are considered medically necessary by the doctor to treat medical conditions such as infection or the risk of developing cancer. Medicare Part B covers qualifying tests and procedures that are done in a doctor’s office or outpatient setting, while Medicare Part A covers medically necessary tests and procedures performed only if the patient has been formally admitted into a Medicare-approved hospital as an inpatient. However, removal of warts for cosmetic purposes or with at-home remedies is not covered through Medicare benefits.

ICD-10 and CPT Codes for Warts

ICD-10 codes for warts include –

  • A18.4 Tuberculosis of skin and subcutaneous tissue
  • A63.0 Anogenital (venereal) warts
  • B07 Viral warts
  • B07.0 Plantar wart
  • B07.8 Other viral warts
  • B07.9 Viral wart, unspecified

Applicable CPT codes are –

  • 11300-11313: Shaving of epidermal or dermal lesions
  • 11400-11446: Excision, benign lesions
  • 17000-17004: Destruction, (such as laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (such as actinic keratoses)
  • 17110-17111, 17250: Destruction, (such as laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular lesions
  • 11102-11107: Include tangential (shave) biopsy, punch biopsy and incisional biopsy

Busy practices can rely on professional podiatry billing and coding services to handle everything from verifying eligibility benefits to submitting insurance claims and tracking down payments.

How Insurance Verification Services Can Benefit a Podiatry Practice

Patient eligibility verification or insurance verification refers to checking a patient’s active coverage with the insurer and verifying the eligibility of his or her insurance claims. Podiatrists need to verify each patient’s eligibility and benefits to ensure they will receive payment for services rendered. As handling insurance is one of the most difficult tasks for podiatry front offices, wound care insurance verification services provided by an experienced medical billing company would be of great support. Submitting claims without proper verification of eligibility is one of the major reasons for claim denials in many specialties. It is crucial that the coverage is verified for both new and existing patients.

The right time to discuss payment and insurance coverage is when the patient calls for appointment. This will save the physician’s as well as the patient’s time. It is also ideal to get the form filled by the patient, which is designed specifically to collect insurance details as well as statements regarding payment responsibility. Professional podiatry billing companies check patient eligibility and benefits at the insurance carrier’s website or by calling up the carrier.

Once the payment is discussed, patients can make more informed decisions regarding the practice’s recommended treatment. Knowing ahead of time what insurance will and will not cover is advantageous for the podiatry practice staff as well.

Verifying patient’s insurance provides diverse benefits such as

  • Submit clean claims
  • Prevent claim denials
  • Avoid delays in payment
  • Accelerate the reimbursement process
  • Improve cash collection
  • Minimize bad debt
  • Increase patient satisfaction
  • Save podiatrist’s valuable time

Some plans may have income restrictions as well. Checking patients’ insurance benefits in advance of their visit will also help the patients realize their payment responsibilities. When it comes to insurance claims processing, even a simple error can result in claim rejection or denial. Often insurance details that need to be verified include effective dates of insurance coverage, co-pay amount for services, payable benefits, co-insurance, deductible amount, status of patient’s insurance policy, pre-authorizations, referrals, mailing address and DME reimbursement.

Eligibility verification process in most companies includes collecting medical billing schedules from healthcare practices, verifying complete patient eligibility on all primary and secondary payers, confirming authorization for treatment and contacting patients for any necessary information. And the final step will be updating the billing system with the verified details. Podiatry practices can avoid tedious in-house verification processes with the support of professional medical billing companies. Make sure that the company you partner with provides the services of skilled verification specialists who are knowledgeable in all facets of insurance processing and podiatric procedures. An experienced hand in podiatry billing, Hippocratic Solutions provides insurance verification service, which can finally end the routine of lengthy claims processing and paper chasing.

Four Most Common Neuropathy Types and Causes [Infographic]

Based on the type and location of the nerves affected, neuropathy is classified into four types: peripheral, cranial, autonomic and focal. Neuropathy can be hereditary or acquired. For podiatrists providing treatment for neuropathy conditions, outsourced podiatry billing is a feasible option for efficient claims submission.

Check out the infographic below

Hippocratic Solutions