[Regina]

Can anyone help me with billing tape to Medicare? We are suddenly having a lot of problems with it.
Thanks as always.

[DeeDee]

Regina,

I don't have a whole lot of insight to offer; however, this is what our manual in Region B states:

TAPE (A4450, A4452):
Tape is covered when needed to hold on a wound cover, elastic roll gauze or non-elastic roll gauze. Additional tape is usually not required when a wound cover with an adhesive border is used. The medical necessity for tape in these situations must be documented. Tape change is determined by the frequency of change of the wound cover. Quantities of tape submitted must reasonably reflect the size of the wound cover being secured. Usual use for wound covers measuring 16 square inches or less is up to 2 units per dressing change; for wound covers measuring 16 to 48 square inches, up to 3 units per dressing change; for wound covers measuring greater than 48 square inches, up to 4 units per dressing change.


What kind of denials/problems are you seeing, specifically?

[Regina]

we are getting denials for modifiers, or lack thereof. It seems no matter how we bill, it gets denied for missing information, even when it bills with the wound care supplies it is used with.

[DMEisgoodfun]

Since it's wound care, are you including modifier AW?

[Regina]

we do, and get a CO-16 denial. Does it need a date span, perhaps?

[MEGL]

You need to add the A1-A9 modifier (how many wounds the patient has) after the aw or you will get a denial for missing information or lacking modifier, unless the tape is not for wound care, you would use the AU modifier for urological/ostomy supplies

[Regina]

I have billed using the A1-9 modifiers, with and without the AW and keep getting denied. Frustrating!