Understanding Coverage, Clinical Evidence, and Audit Preparedness in Skin Substitute Treatments
As Medicare prepares to implement the proposed Local Coverage Determination (LCD) for Diabetic Foot Ulcers (DFUs) and Venous Leg Ulcers (VLUs), healthcare providers face increased scrutiny through intensified audit activities—including UPIC, RAC, and TPE audits. These audits are placing heightened emphasis on clinical documentation and the medical necessity of skin substitute products.
Speaker: Jeffrey Lehrman DPM FASPS MAPWCA CPC
Host: Gunnar Johannsson MD
Join us for an essential webinar designed to equip providers with clarity on:
What the Proposed LCD Means for Providers
• Coverage Criteria: DFUs and VLUs versus other wound types
• Clinical Evidence: Why certain products, like Kerecis, were included
• Effective Date: When changes will come into effect, and implications if the LCD doesn’t go forward
Understanding Medicare Audits
• Types of Audits: What differentiates UPIC, RAC, and TPE audits?
• Audit Triggers: Common reasons audits are initiated, particularly around medical necessity and documentation
Preparing for and Navigating Audits
• Compliance Preparation: Knowing and following the rules proactively, before an audit is initiated
• Documentation Best Practices: Implementing compliant record-keeping before receiving any audit notice
• Legal Implications: Understanding audits as legal processes between providers and payers
• Critical Timelines: What documentation changes can be made once records are requested
Protecting Your Practice
• Administrative Defense Coverage: What is it, and why it’s essential
• Activation and Engagement: Steps to promptly activate and leverage your administrative defense coverage
• Contact Guidance: Knowing whom to contact (and whom not to contact) when an audit is initiated
Don’t face policy changes unprepared.
Join us and ensure your practice remains compliant, confident, and protected amidst these significant changes in wound care reimbursement and Medicare audits.
