by Caroline Fife, M.D. | Nov 6, 2023 | Fight the Good Fight, Medicare Audits
I have been posting information from the MAC websites about audits and required documentation, particularly for HBOT since that’s a huge audit focus. I got an email from a colleague in the Palmetto jurisdiction who for many months has been fighting denials for HBOT in...
by Caroline Fife, M.D. | Nov 1, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I have been trying to identify the problems in the CTP/skin sub industry in hopes that doing so could inform specific policy changes. Many weeks ago, the Alliance of Wound Care Stakeholders made five specific recommendations to Centers for Medicare & Medicaid...
by Caroline Fife, M.D. | Oct 31, 2023 | Fight the Good Fight, Medicare Audits
This is part of my series of articles about Useful Information on Medicare Audits. Palmetto is the MAC for: Region J: Alabama, Georgia, Tennessee (Region J) Region M: North Carolina, South Carolina, Virginia, West Virginia (excludes Part B for the counties of...
by Caroline Fife, M.D. | Oct 26, 2023 | Fight the Good Fight, The Patient's Voice
I have been like a dog with a bone trying to get to the bottom of the CTP/Skin substitute quagmire, but I don’t want to lose sight of other important things. A few months ago, I heard Suzanne Molony give a presentation at a conference and I thought, “Everyone should...
by Caroline Fife, M.D. | Oct 17, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I previously posted this ad from Linked in which has since been taken down. At the time, I thought it was some kind of joke. However, in the past few weeks, the way in which practitioners can make huge profits off the cost of a product has been explained to me. That...
by Caroline Fife, M.D. | Oct 16, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
…With a Question About the per CM Sq. Price Variations for Products Check out the entire series here. I am in the Novitas Medicare Jurisdiction and I keep an eye on their Medicare Newsletter. Here are the instructions for submitting claims for CTPs/skin subs...
by Caroline Fife, M.D. | Oct 13, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Check out the entire series here. I know this story qualifies as hearsay. I could provide the names of the companies involved, but I can’t afford the legal bills. Since I can’t provide the details, you don’t know whether to believe me, but here goes: A doctor called...
by Caroline Fife, M.D. | Oct 12, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Check out the entire series here. In 2015, CMS moved to “package pricing” for CTPs/skin subs in the hospital-based outpatient clinic. When that happened, the cost of the product was incorporated into the charge for the visit, and that caused a sudden and dramatic...
by Caroline Fife, M.D. | Oct 10, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Check out the entire series here. Here’s another message that I agreed to post anonymously that asks many questions we are asking: Why are two products made in the same tissue lab and identical as far as any of us can tell, priced completely differently, with one of...
by Caroline Fife, M.D. | Oct 9, 2023 | Fight the Good Fight, Lymphatic Imaging & Lymphedema
There is increasing awareness that not only does chronic illness negatively impact mental health, but that conditions like depression negatively impact the effectiveness of treatment! Many thanks to Eric Ansart for reminding us about the impact of lymphedema on mental...
