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I have posted a lot of articles about why under Medicare’s Quality Payment Program (QPP), the future of wound care practitioners is in jeopardy because we do not have a recognized specialty. In 2017 when CMS was still providing very detailed performance reports (which they stopped doing), my perfect score for the Merit Based Incentive Payment Program (MIPS) could not compensate for my “spending” on Medicare patients. That’s because under MIPS, CMS compares a physician’s spending to their peers IN THE SAME MEDICAL SPECIALTY. Because I am a family practice doctor, CMS compared my spending on Medicare patients with all the other FPs in the country. Despite the fact that my patients were FOUR TIMES MORE COMPLICATED, based on my average patient HCC (Hierarchical Classification Code), my spending was in the top 2% of all FPs in the country that year, so CMS gave me the lowest score possible on the “cost score” aspect of MIPS. From Today’s Wound Clinic: The Handwriting on the Wall for Wound Management

That’s why I suggested that all wound care practitioners change their specialty taxonomy to “Undersea and Hyperbaric Medicine” (UHM) because that’s the closest thing to a wound care specialty code.

I have a question I need help with. There IS a taxonomy code for wound care nursing service providers: 163WW0000X.

I have the following questions for anyone who understands nursing taxonomy codes:

  • Since RNs do not have to participate in MIPS, what’s the point of this taxonomy code – what is it used for?
  • Can this code be used by Nurse Practitioners (NPs) and physician assistants (PAs)?
  • Does this taxonomy confer any benefit to a wound care physician who employs NPs?

Message me with your answers and I will post them.

–Caroline

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