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Surgical Dressing Order Requirements

The purpose of this article is to reiterate the surgical dressing order requirements as indicated in the respective LCD and policy article available on our Web site.

Surgical Dressings

A separate, detailed written order, completed by the treating physician, must specify:

  1. the type of dressing (e.g., hydrocolloid wound cover, hydrogel wound filler, etc.);
  2. the size of the dressing (if appropriate);
  3. the number/amount to be used at one time (if more than one);
  4. the frequency of the dressing change; and
  5. the expected duration of need.

Example: One 4Ă—4 hydrocolloid dressing that is changed 12 times per week for one month or until the ulcer heals.

  • A new order is needed if a new dressing is added or if the quantity of an existing dressing to be used is increased. A new order is not routinely needed if the quantity of dressings used is decreased. However, a new order is required at least every three months for each dressing being used even if the quantity used has remained the same or decreased.

You must provide the detailed written order within a timely manner upon request by the DME MAC and/or PSC.

Surgical Dressing Order Requirements
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