(HE-001) Billing Discrepancies Using Photo Documentation That Measures True Surface Area Versus Conventional Measurements of Length x Width
Co-Author(s):
Introduction: Wound measurements using a ruler to measure length x width x depth is traditionally used at many wound care clinics. However, this conventional measurement technique tends to over estimate the true surface area of the wound. Photo documentation using SWIFT skin and wound app measures the true surface area even irregular shaped wounds.
It was found that there was upcoding of debridement codes using traditional wound care measurements versus photo documentation programs that measures the true surface area
Methods: For the month of May 2022:
The nursing staff measured each patient's wound using the traditional paper ruler length x width
A repeat measurement was done using SWIFT skin and wound app
A spreadsheet was created using the total surface area measurements comparing which debridement codes would be used based on each 20 centimeter squared area. This was done for both traditional paper ruler measurements and Swift skin and wound app photo documentation.
Measurements were done for both selective and surgical debridements.
Results: The traditional wound measurements using paper ruler tended to upcharge the debridement codes secondary to over estimating the surface area of a majority of wounds.
Discussion: Issues that require further investigation:
1 - Only one photo documentation software was used - Will the above results be replicated using other software?
2 - Although using photo documentation software that measures true surface area potentially saves Medicare and/or commercial insurances revenue, it will inadvertently decrease health care provider and/or wound care facilities revenue.