back

Elaine Horibe Song, MD, PhD, MBA

Physician - MD/DPM/DO
Other, Wound care, Plastic Surgery
Elaine Horibe Song's Background
Dr. Song is a Co-Founder and Chief Executive Officer of WoundReference, Inc., a clinical and reimbursement decision support & telemedicine platform for wound care and hyperbaric clinicians. With a medical, science and business background, Dr. Song previously served as medical director for a regenerative medicine-focused biotech company in California, and for a Joint Commission International-accredited hospital network. Dr. Song also served as a management consultant for Kaiser Permanente, practiced as a plastic surgeon in private practice and academia, and conducted bench and clinical research in wound healing, microsurgery and transplant immunology. Dr. Song holds a position as Affiliate Professor, Division of Plastic Surgery, Federal University of Sao Paulo, and is a volunteer Communication/Website Committee, Association for the Advancement of Wound Care. She has authored more than 200 scientific publications, book chapters, software registrations and patents.

About Wound Reference
WoundReference is the only decision support platform designed exclusively for wound care and hyperbaric oxygen clinicians. Our point-of-care tools enable clinicians to work more efficiently.

Chair, Association for the Advancement of Wound Care,  ResearchGate Profile

line 2

  • Patient Education - Radiation-induced cutaneous damage - Acute Effects
    Radiation-induced cutaneous damage (RICD) is a common side effect of radiation therapy. Initial skin changes caused by radiation (acute effects) are usually seen within 90 days from the day the patient receives radiotherapy. This evidence-based topic for patients and caregivers answers common questions related to acute effects of RICD. It can be printed at the point-of-care or digitally shared with patients.
  • Radiation-Induced Cutaneous Damage - Treatment, Prevention, Patient Education
    Radiation-induced cutaneous damage is a common sequela of radiation exposure. This topic describes management of acute and late effects of radiation
  • Radiation-induced Cutaneous Damage - Introduction and Assessment
    SUMMARY Radiation-induced cutaneous damage is a common sequela of radiation exposure, affecting up to 95 percent of patients who receive radiotherapy.(1–3) Skin damage can be either acute or chronic, based on the timing of presentation. Acute damage occurs within 90 days of exposure, and is dose dependent, ranging from transient erythema, to dry a
  • Pressure Ulcers/Injuries - Guidelines and Quality Measures
    Pressure ulcer/ pressure injury overview: updates on terminology, evidence-based clinical guidelines, quality measures and resources
  • Compression Therapy
    Compression therapy is considered the mainstay of venous leg ulcer (VLU) treatment and along with standard care has the potential to heal 50%-75% of VLU. This topic provides an overview on the use of compression therapy in the treatment of VLU with evidence-based recommendations
  • Patient Education - Radiation-induced cutaneous damage - Late Effects
    Summary Radiation-induced cutaneous damage (RICD) is a common side effect of radiation therapy that affects your skin. As much as 95 percent of all patients receiving radiation therapy will experience some form of RICD. (Bray et al. 2016). The initial skin changes (acute effects) caused by radiation usually heal after radiotherapy is completed, but the late skin changes (chronic effects) can develop mon
  • Venous Ulcers - Treatment and Prevention
    Venous Leg Ulcers (VLU) are relatively common, affecting 1% of the population in the U.S. This topic discusses treatment and prevention of VLU. Evidence-based management of venous ulcer, including a section for clinicians on patient education. Concise Algorithm for Management of Venous ulcer for use of point-of-care.
  • Medicare Billing Protocol and Workflow
    Hyperbaric oxygen therapy Medicare billing workflow for wound and hyperbaric therapy clinics.
  • Medicare Billing Protocol - Appeal of Claim
    Hyperbaric Oxygen Therapy Overview of the Medicare Claim's Appeal Process
  • Dressing Essentials
    Practice essentials on dressings. Summarized information on the main types of dressing used in wound management, organized in a practical tool
  • Medicare Targeted Probe and Educate Protocol
    The Centers for Medicare and Medicaid (CMS) Targeted Probe and Educate (TPE) Process is designed to help providers and suppliers reduce claims denials and appeals through one-on-one help. This topic provides guidance on how to successfully navigate the TPE process. It includes information on additional documentation request and latest results of recent TPE findings.
  • Cellular and/or Tissue Based Products
    Evidence-based topic on cellular and/or tissue products (also known as human skin equivalents, or skin substitutes) - clinical, coverage and reimbursement updates.
  • How to Select Cellular and/or Tissue Products
    This topic provides guidance on selection of Cellular and/or Tissue Products (CTPs) with an interactive framework
  • HBO Initial Patient Evaluation
    Overview of an initial patient evaluation for Hyperbaric Oxygen Therapy
  • HBO Physician Orders Overview
    Physician order sets for Hyperbaric Oxygen Therapy
  • HBO Treatment Indications With Protocols
    Hyperbaric Oxygen Therapy Treatment Protocol Guidelines and Indications
  • HBO Threshold Levels
    Hyperbaric Oxygen Therapy treatment threshold levels (lower limit, upper limit/utilization review)
  • Acute Carbon Monoxide Poisoning
    Hyperbaric oxygen therapy (HBOT) protocol for acute carbon monoxide with GRADE recommendation, review of recent evidence, checklist, sample documentation statements. Approved for 1 Category A Continuing Education Credit by the NBDHMT
  • Acute Exceptional Blood Loss Anemia
    Hyperbaric oxygen therapy (HBOT) protocol for Acute Exceptional Blood Loss Anemia, documentation template and GRADE assessment of current evidence
  • Acute Peripheral Arterial Insufficiency
    Hyperbaric oxygen therapy (HBOT) protocol for Acute Peripheral Arterial Insufficiency
  • Acute Traumatic Ischemia, Crush Injury and Compartment Syndrome
    Hyperbaric oxygen therapy (HBOT) protocol for acute traumatic peripheral ischemia, crush injury and compartment syndrome with GRADE recommendations, review of recent evidence, checklist, sample documentation statements
  • Central Retinal Artery Occlusion
    Hyperbaric oxygen therapy (HBOT) protocol for Central Retinal Artery Occlusion
  • Clostridial Myonecrosis (Gas Gangrene)
    Hyperbaric oxygen therapy for treatment of clostridial myonecrosis. Evidence-based protocol, sample physician order template and documentation templates to support HBO indication. Operational considerations and nursing interventions
  • Compromised Skin Grafts and Flaps
    Hyperbaric oxygen therapy for treatment of compromised flaps and skin grafts (including mutilated limb injuries), with evidence, sample documentation statements, checklists.
  • Decompression Illness and Arterial Gas Embolism
    Hyperbaric oxygen therapy for treatment of decompression illness and arterial gas embolism, evidence-based protocol, sample physician orders, documentation statements, evidence-based GRADE recommendations. Category A Continuing Education Credit
  • Diabetic Foot Ulcer - Hyperbaric Oxygen Therapy
    Hyperbaric oxygen therapy (HBOT) protocol for patients with diabetes with lower extremity ulcers
  • Venous ulcers - Introduction and Assessment
    Concise Algorithm for Assessment of Venous Ulcer for use at point-of-care. Comprehensive topic including epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding. Free Abstract Summary
  • Idiopathic Sudden Sensorineural Hearing Loss
    Hyperbaric oxygen therapy (HBOT) protocol for Idiopathic Sudden Sensorineural Hearing Loss, with evidence-based graded recommendations, sample documentation statements, physician order template, checklists.
  • Pyogenic and Invasive Fungal Intracranial Abscesses
    Hyperbaric oxygen therapy for treatment of pyogenic and invasive fungal intracranial abscesses, evidence-based protocol, sample physician order template
  • Necrotizing Soft Tissue Infections And Fournier's Gangrene
    Hyperbaric oxygen therapy for treatment of necrotizing soft tissue infections and Fournier's gangrene, protocol with evidence, sample physician order template and documentation guidance/template
  • Osteoradionecrosis - Mandibular
    Hyperbaric oxygen therapy (HBOT) protocol for osteoradionecrosis (mandibular), with evidence, sample documentation statements, checklists
  • Soft Tissue Radiation Necrosis
    Hyperbaric oxygen therapy (HBOT) protocol for soft tissue radiation injury, with evidence, sample documentation statements, checklists
  • Venous Ulcers - Guidelines and Quality Measures
    Venous leg ulcer overview: evidence-based clinical guidelines, quality measures and resources
  • Diabetic Foot Ulcers - Clinical Guidelines and Quality Measures
    Diabetic foot ulcers overview: evidence-based clinical guidelines, quality measures and resources
  • Diabetic Foot Ulcer - Introduction and Assessment
    A diabetic foot ulcer (DFU) can be defined as a full-thickness wound below the ankle, or as a lesion of the foot penetrating through the dermis, in people with type 1 or type 2 diabetes.
  • Diabetic Foot Ulcer - Treatment
    Diabetic foot ulcer (DFU) management with a concise algorithm which can be used at the point-of-care
  • Diabetic Foot Ulcer - Prevention
    Diabetic Foot Ulcers (DFUs) are a chronic problem. Recurrence rates range from 8–59% however, up to 75% of DFUs may be preventable. Therefore, long-term maintenance must be addressed even for healed ulcers to prevent recurrence.
  • Diabetic Foot Ulcer Associated with Ischemia - Management
    ABSTRACTVenous Leg Ulcers (VLU) are relatively common, affecting 1% of the population in the U.S.[1] VLU can be defined as an open skin lesion of the leg or foot t
  • Diabetic Foot Ulcer Associated with Infection - Management
    Topical agents, systemic antibiotics surgical interventions for diabetic foot ulcers soft tissue infection
  • Diabetic Foot Ulcers - Classification Systems
    Diabetic Foot Ulcer Classifications - Wagner, University of Texas, WIfI, IDSA. Actionable tables with pictures and documentation tips for proper ICD-10 coding
  • How to Apply Cellular and/or Tissue Based Products
    Practical guidance with step-by-step pictures, protocol and tips on how to apply different types of cellular and/or tissue products (CTPs), also known as skin substitutes
  • Pressure Ulcers/Injuries - Classification/Staging
    This topic provides pictures and details on two of the most used classification systems for pressure ulcer/injury (PU/PI): the classification created by the National Pressure Ulcer Advisory Panel (NPUAP) and the system adopted by the Centers for Medicare and Medicaid Services (CMS)
  • Pressure Ulcers/Injuries - Introduction and Assessment
    Framework for assessment of patients with pressure ulcers/injuries. Includes concise abstract, clinical pathway/algorithm for use at the point-of-care, and comprehensive resources on the condition (e.g. epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding)
  • Chronic Refractory Osteomyelitis
    Hyperbaric oxygen therapy (HBOT) protocol for chronic refractory osteomyelitis, with evidence, sample documentation statements, checklists
  • What is new in 2019 for Telehealth and Telemedicine?
    2019 is a landmark for Telehealth services - The Centers for Medicare & Medicaid Services will start to reimburse healthcare providers for a broader range of telehealth services. This post provides an overview of telehealth and telemedicine and updates regarding newly covered services.
  • Negative Pressure Wound Therapy
    This topic provides an updated evidence-based review and reimbursement policies on the use of Negative Pressure Wound Therapy (NPWT), with a focus on chronic wounds.
  • Pressure Ulcers/Injuries - Treatment
    Pressure Ulcers/Injuries - evidence-based, always current review on management with a concise algorithm/pathway for use at the point-of-care
  • Other Biophysical Agents
    This topic covers biophysical agents used to treat wounds. Electromagnetic stimulation (ES), pulsed electromagnetic field therapy (EMT/PEMF), diathermy, therapeutic ultrasound and phototherapy. This topic will be expanded to include clinical information soon. A list of Medicare national and local coverage determinations can be found under section 'Coding, Coverage and Reimbursement'
  • Pressure Ulcers/Injuries -Coordination of Care
    Coordination of care for prevention and management of pressure ulcers/injuries - problems and practical solutions
  • Pressure Ulcers/Injuries - Prevention
    Pressure ulcers/injuries (PUs/PIs) pose a large burden to affected individuals, caregivers and healthcare systems. As in any illness or injury, preventing PUs/PIs is better than treating them. This topic presents evidence-based interventions for prevention of PUs/PIs, with best practices and recommendations summarized in a concise table.
  • Case: How 20 minutes of fun can cost 4 months of disruption
    This case illustrates how a seemingly innocent decision in the life of a person at risk for pressure ulcer/injury (PI/PI) can lead to a new episode of PU/PI
  • Patient Education - Diabetic Foot Ulcer
    Diabetic Foot Ulcers for patients and caregivers. The topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Case: When Pressure Ulcer/Injury Happens...
    This case illustrates real world obstacles that lead to scenarios of increased likelihood of unavoidable pressure ulcers/injuries (PUs/PIs) and delayed transition of care.
  • Acute Burns - Introduction and Assessment
    This topic provides an evidence-based review and framework for assessment of acute burns, including epidemiology, risk factors, etiology, pathophysiology, first aid, primary and secondary assessment, transfer criteria, burns classification, documentation and ICD-10 coding
  • Acute Burns - Guidelines and Quality Measures
    Acute Burn Injury overview: evidence-based clinical guidelines, quality measures and resources
  • Hyperbaric Program Staffing Guidelines
    Staffing guidelines for hyperbaric medicine departments. Roles and responsibilities, staffing ratios, staffing considerations
  • Lymphedema - Guidelines and Quality Measures
    Lymphedema overview: evidence-based clinical guidelines, quality measures and resources
  • Lymphedema - Introduction and Assessment
    Evidence-based review on lymphedema. Framework for assessment of patients with lymphedema. Includes concise abstract and comprehensive resources on the condition (e.g. epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding)
  • MIPS in Wound Care and Hyperbaric Medicine
    Collection period for MIPS Year 3 started in January 1st, 2019. In 2019, CMS expanded the types of clinicians who are subject to participation in MIPS, and implemented other updates. This blog post summarizes some of these changes and provides an overview on how WoundReference can help eligible clinicians and groups perform well in MIPS.
  • Lymphedema - Treatment and Emerging Strategies for Prevention
    Evidence-based, always current review on lymphedema management with a concise algorithm/pathway for use at the point-of-care
  • Staffing Guidance for Wound Care Centers
    Guidance on lean staffing for wound care centers. Identification of variables that impact staffing, staffing tool and tips
  • Lymphedema - Surgical Management
    For well-selected patients with chronic lymphedema, surgical management offers a chance for reduction of limb volume, decreased episodes of infection and improved quality of life. This topic provides updates on recent surgical advancements, along with specific indications and guidance on preoperative evaluation.
  • How to set up and optimize your wound care formulary
    Save time and money with a well planned wound care formulary. Learn how to setup an institutional formulary to better manage your inventory of dressings and bandages.
  • How to Interpret Audible Handheld Doppler Ultrasound and Waveforms to Rule out PAD
    Audible handheld Doppler ultrasound and waveforms have been gaining acceptance as a tool for bedside non-invasive arterial assessment of lower limbs. This topic provides a primer (includes videos) on how to perform and interpret audible handheld doppler and waveforms to detect peripheral artery disease.
  • How to Select Adequate Compression Therapy Pressure Levels and Products
    Compression therapy is essential for patients with venous leg ulcer, lymphedema and other conditions. This topic provides algorithms that illustrate how audible handheld Doppler ultrasound/ waveform analysis or ankle-brachial index can be utilized to determine appropriate pressure levels and types of compression across different clinical scenarios.
  • Patient Education - Hyperbaric Oxygen Therapy for Diabetic Foot Ulcer
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for diabetic foot ulcers can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Pyoderma Gangrenosum - Introduction and Assessment
    Pyoderma gangrenosum is a rare but serious primary ulcerating condition of the skin that falls into the category of neutrophilic dermatoses. This topic provides a framework for assessment of patients with pyoderma gangrenosum. Includes concise abstract, clinical pathway/algorithm for use at the point-of-care, and comprehensive resources on the condition (e.g. epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding)
  • WoundReference publishes new study on Instant Personalized Product Handouts
    The WoundReference Team has just published the study entitled 'A New Mobile-responsive Solution to Increase Patient Adherence: Instant Personalized Product Handouts' on the journal Wounds: a Compendium of Clinical Research and Practice. Find out how WoundReference Instant Personalized Product Handouts have been saving clinicians time and helping improve patient adherence.
  • Pyoderma Gangrenosum - Treatment
    Pyoderma gangrenosum is a rare but serious primary ulcerating condition of the skin that falls into the category of neutrophilic dermatoses. Currently, there is no definitive guideline or gold standard in management of pyoderma gangrenosum, as data from controlled clinical trials are scarce. This topic provides an evidence-based, always current review on management of pyoderma gangrenosum, with a concise algorithm/pathway for use at the point-of-care
  • Patient Education - Hyperbaric Oxygen Therapy for Chronic Refractory Osteomyelitis
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for chronic refractory osteomyelitis can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient education - Lymphedema
    Topic on lymphedema and its complications for patients and caregivers. The topic can be shared with patients and caregivers by email or print.
  • Patient Education - Hyperbaric Oxygen Therapy for Soft Tissue Radiation Injury
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for soft tissue radiation injury can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Osteoradionecrosis
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for osteoradionecrosis can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Case: New-onset cutaneous vasculitis
    Wound care clinicians often face challenging ulcers that have been previously treated with little or no success by other healthcare providers. Some of these ulcers are related to cutaneous vasculitis. This topic describes how an atypical lower extremity ulcer was diagnosed as new-onset cutaneous vasculitis at a wound care clinic.
  • Cutaneous Vasculitis
    INTRODUCTIONBackgroundDefinition:Vasculitis of the skin (cutaneous vasculitis) includes several inflammatory disorders that compromise blood vessels and specifically the cutaneous vascular system (i.e. arterioles, capillaries, postcapillary venules), and lead to cutaneous changes. (Papi and Papi 2016) According to the 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides (CHCC2012), cutaneous vasculitis can present in 3
  • Acute Burns - Treatment
    Evidence-based, always current review on management of acute burns.
  • MIPS in Wound Care and Hyperbaric Medicine - Improvement Activities
    The MIPS Improvement Activities Category is one of the four categories comprising the Centers for Medicare and Medicaid Services (CMS)'s Merit-based Incentive Payment System (MIPS). MIPS is part of the CMS Quality Payment Program (QPP), in which eligible clinicians are required to participate during 2019 to avoid a negative impact on the physician fee payment for the year of 2021. This blog post provides a summary on the
  • Quality in Wound Care
    This topic provides an update on Quality in wound care and how clinical decision support systems like WoundReference can help clinicians achieve better outcomes more efficiently. The topic lists resources such as a quality framework intended to be used for creation or assessment of wound care services, algorithms demonstrating application of evidence in product selection, quality measures specific to wound care, and guidance for wound and hyperbaric programs to successfully navigate the CMS Quality Payment Program (MIPS).
  • Case: Circumferential Negative Pressure Wound Therapy
    Use of compression therapy to reduce edema on patients with complex chronic leg ulcers can be challenging or contraindicated. Negative Pressure Wound Therapy (NPWT) circumferential dressing may be an option for complex cases.
  • Documentation: Hyperbaric Treatment Notes by the CHRN and CHT
    To ensure audit-readiness and smooth reimbursement, facility and physician charges related to wound care and hyperbaric oxygen services must be validated with documentation from both physician AND non-physician providers (i.e.,Certified Hyperbaric Registered Nurses and Certified Hyperbaric Technologists). The CHRN or CHT note is proof and validation that a treatment was provided and billed by the facility (G0277). This topic provides a template for hyperbaric treatment records documented by non-physician providers.
  • Case: Managing High-output Enteroatmospheric Fistulas - A Case Study and Review
    Fistulas with high amount of drainage (i.e., with high-output), or fistulas that appear in an open abdomen with no overlying soft tissue (i.e., enteroatmospheric fistulas, or EAFs) can pose a real challenge to wound and ostomy specialists. This topic illustrates a case in which a fistula isolation device was used in conjunction with negative pressure wound therapy to manage a high-output EAF. The topic also provides a summarized review on treatment of enterocutaneous and enteroatmospheric fistulas.
  • Designation of Hyperbaric Safety Director
    This topic elaborates on the role of a Hyperbaric Safety Director, including aspects related to designation, training/education and a sample policy and procedure. Authors also explain the rationale behind having a formally designated and specifically trained Safety Director in each hyperbaric medicine facility. Designation of the Safety Director in writing and an appropriate job description for the role are paramount to hyperbaric facility safety.
  • Staff Minimum Qualifications and Training for HBOT
    Regardless of the the purpose and scope of the hyperbaric facility, inadequate knowledge of applicable gas laws, chamber fire safety, potential risks, side effects, and contraindications of hyperbaric medicine, may result in dangerous situations that risk patients' and personnel's well-being. This topic elaborates on the minimum qualifications and training/education for hyperbaric staff, and provides policies that can be adjusted and adopted by hyperbaric programs.
  • How to Determine Healability of a Chronic Wound
    As a prerequisite to setting realistic treatment objectives, chronic wounds should be classified according to their ability to heal, that is, as healable, nonhealable, or maintenance. This designation defines for the clinician, patient, and family an expected course of action, plan of care, and healing rate. It also facilitates responsible use of available resources along with realistic treatment goals. This topic serves a tool to help clinicians assess wound healability.
  • Internal Medical Documentation Auditing
    Payers frequently audit providers. Internal medical documentation audits are necessary to determine areas that require improvements and corrections. To be ready for audits by payers, the documentation, including HBO consultation note, physician orders and daily HBO progress note must meet medical necessity requirements. This topic provides a lean protocol on how to conduct internal medical documentation audits to help ensure audit-readiness.
  • Safety and Hyperbaric Oxygen Therapy
    Creating and maintaining an environment of safety in the hyperbaric facility is achieved through proactive planning and attention to detail. Lack of proper safety protocols and procedures causes accidents, and, unfortunately, loss of life. While we never want to have a disaster, we learn from safety analysis of them. This topic provides a summarized update on Safety in the Hyperbaric Facility. The topic also provides guidance and resources that will help you build an excellent hyperbaric safety program. Resources include safety guidelines, job descriptions, go-no-go lists, go-no-go risk assessment tool, and emergency procedures.
  • Debridement
    Debridement is an important step in optimizing a wound or ulcer for functional healing. This evidence-based topic provides clinical, coverage and reimbursement updates on debridement methods in wound management (e.g., surgical, sharp conservative, mechanical, autolytic, enzymatic, larval, hydro-mechanical, etc). Includes indications, contraindications, GRADE recommendations, documentation guidance, links to Medicare coverage determinations by each Medicare Administrative Contractor.
  • Patient Education in Wound Care and Hyperbaric Oxygen Therapy
    Patient and caregiver education is central to patient-centered, value-based care. It can be a differentiating factor for wound care and hyperbaric oxygen therapy (HBOT) services looking to offer the highest standards of clinical practice. This topic provides an update on the importance and benefits of patient education in wound care and HBOT, current gaps, commonly used methods, and resources to develop patient education programs in wound care and HBOT. It lists 5 tools that can be implemented today to streamline patient education at the point-of-care, and provides a downloadable framework with best practices on patient education in wound care and HBOT.
  • Patient Education - Hyperbaric Oxygen Therapy for Chronic Refractory Osteomyelitis (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for chronic refractory osteomyelitis can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Compromised Grafts and Flaps (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for compromised skin grafts and flaps can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Venous Leg Ulcers (Spanish)
    Venous leg ulcer for patients and caregivers in SPANISH. This illustration-rich topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Patient Education - Hyperbaric Oxygen Therapy for Diabetic Foot Ulcer (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for diabetic foot ulcers can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Diabetic Foot Ulcer (Spanish)
    Diabetic Foot Ulcer for patients and caregivers in SPANISH. This illustration-rich topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Global Surgical Transfer of Care to the Wound Clinic
    Wound physicians must be aware of the surgical global packaging rules as they relate to the transfer of care from one provider to another. Documentation and proper billing methods are essential to meet CMS compliance standards and to ensure the rules are followed. Failure to do so could make the wound care provider a target for audit and denials. This topic provides guidance and a protocol for global surgical transfer of care. Normal 0
  • Patient Education - Hyperbaric Oxygen Therapy for Osteoradionecrosis (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for osteoradionecrosis of the mandible can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • How to Perform Conservative Sharp Wound Debridement
    This topic provides practical guidance on how to perform conservative sharp wound debridement, assess effectiveness, troubleshoot, code and document each procedure. See step-by-step protocols with pictures, video, checklists and documentation template.
  • Errors and Healthcare
    Patient safety is a serious public health issue. Like obesity and motor vehicle crashes, harms caused during care have significant mortality, morbidity, quality-of-life implications, and adversely affect patients in every care setting. This topic provides a snapshot of current patient safety facts, helpful definitions in Patient Safety, factors that lead to errors, liability in Wound and Hyperbaric Oxygen Therapy Programs, and actions that can be implemented to improve Patient Safety and reduce errors.
  • Billing 101 for Hyperbaric Providers
    INTRODUCTION99183- Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per sessionG0277- Hyperbaric oxygen under pressure, full body
  • Telemedicine/ Televisit Implementation Playbook - Part 1
    Telemedicine can be a plausible option to do more with less in wound care. The purpose of the first part of this playbook is to guide healthcare professionals in assessing the benefits telemedicine can bring to their practices.
  • How to Apply Unna Boot
    Unna Boot, also known as Unna's Boot or paste boot, is an inelastic bandage that is frequently used in compression therapy to treat venous leg ulcers. Application of UB is one of the most common clinic procedures billed to Medicare. This topic provides practical guidance on how to apply an Unna Boot, assess effectiveness, troubleshoot, code and document each application. See step-by-step protocol, and documentation checklist.
  • Case: New Technique to Seal Negative Pressure Wound Therapy on Exposed Dermis
    Negative pressure wound therapy (NPWT) has the potential to expedite healing and may be applied in many clinical situations, but achieving and maintaining a reliable, occlusive seal is requisite to realize benefit and mitigate cost, regardless of NPWT type. This topic illustrates a new method to achieve effective seal of an open abdomen NPWT dressing on a highly exudative deepithelialized periwound lacking any dry tissue to apply adhesive drape.
  • Skin Tears - Introduction and Assessment
    Framework for assessment of patients with skin tears. Includes concise abstract, clinical pathway/algorithm for use at the point-of-care, and comprehensive resources on the condition (e.g. epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding)
  • Hyperbaric Certification and Continuing Education for Technologists & Nurses
    This blog post provides an overview on the importance of Hyperbaric Certification for Technicians and Nurses, as well as recertification and continuing education requirements
  • Patient Education - Nutrition for Wound Healing : Understanding the Basics
    This topic for patients and caregivers explains the importance of food, and how it can help wounds heal. It answers questions such as "Why is it important for me to eat well when I have a wound?" and "What should I eat"? Includes handouts on food groups, vitamins and minerals
  • Patient Education - Nutrition for wound healing : What if I have other health conditions?
    What should I do if I have diabetes mellitus, kidney disease, high blood pressure, food allergies, and other conditions that affect what I eat? Topic for patients and caregivers.
  • Skin Tears - Treatment and Prevention
    Topic on skin tear management and prevention, with a concise algorithm which can be used at the point-of-care
  • Offloading Devices
    This topic provides a review and updates on offloading devices for diabetic foot ulcers (DFUs), from the clinical, coverage and reimbursement perspectives.
  • Webinar: Unwrapping Venous Ulcers - Assessment and Management
    Sign up for a Free Basic Account to watch this webinar co-produced by MidAmerica Wound Healing Society and Wound Reference.
  • How to Select Offloading Devices
    This topic provides guidance on selection of Offloading Devices with an interactive framework
  • Patient Education - Nutrition for wound healing in action - Step 4: What if I don’t cook?
    What if I don’t cook? One of the greatest challenges to having optimal nutrition is time. Fresh, healthy foods can be delicious when prepared right. But this requires certain skills and experiences in the kitchen, as well as enough time to prepare, cook, and eat your meal. Meal preparation can be mentally exhausting, especially with the added stress and pressure from a wound that needs to heal. Explore available options.
  • Patient Education - Nutrition for wound healing in action - Step 3: Shop smartly
    Label reading - one of the keys to smart grocery shoppingGrocery shopping can be overwhelming; with the abundance of options, how do you choose what is right for you? Luckily all foods have nutritional labels. They are called the ‘Nutrition Facts’ label. Learning how to read them correctly is incredibly important! Table 1 below shows some simple steps to assist in your label reading. Table 1. How to read the Nutrition Facts label on food products. Adapted from the Acade
  • Patient Education - Nutrition for wound healing in action - Step 2: Leverage supplements
    What is oral nutritional supplementation? In addition to the balanced meals suggested in the topic nutrition, oral supplementation may be recommended by your healthcare professional. Oral Nutritional Supplementation (ONS) is a way to provide your body with additional macro and micronutrients that may be lacking in your diet.
  • Patient Education - Nutrition for wound healing in action - Step 1: Map out your meals
    What does a balanced meal plan look like? The goal of any healthy diet is to have a balanced meal combined with oral supplementation as recommended by your healthcare professional. Oral supplementation are products (in the form of liquids, powders, capsules/tablets) that provide additional nutrients for the body when ingested. Oral supplementation may not be necessary for everyone but can help boost levels of nutrients that you may be missing.
  • 3 Ways Telemedicine Can Help Wound Care Clinicians Combat the New Coronavirus (COVID-19)
    Find out how wound care and HBOT clinicians can leverage telemedicine to continue to care for their patients in a safe manner.
  • Surgical Ostomy for Fecal Diversion
    Stomas or ostomies are surgically created openings connecting a hollow organ to the skin. This topic provides an overview on the several types of stomas, with a focus on colostomies and ileostomies. It includes descriptions of most common surgical techniques, indications, contraindications, pre and postoperative care, and stomal complications (e.g. ischemia, necrosis, retraction, stenosis, prolapse, varices, hernia).
  • Reimbursement for Telemedicine Services in Wound Care
    This blog article summarizes coding, coverage and reimbursement information on some of the telemedicine services that are relevant to the wound care healthcare professional
  • Telemedicine/ Televisit Implementation Playbook - Part 2
    Telemedicine can be a plausible option to do more with less in wound care. This is the second installment of the Telemedicine/ Televisit Implementation Playbook. The first installment guides healthcare professionals in assessing the benefits telemedicine can bring to their practices. This topic provides a practical pathway for implementation of telemedicine solutions.
  • Case: Surgical offloading of a lesser toe DFU with flexor tenotomy
    This case demonstrates a classic presentation of a lesser toe diabetic foot ulcer which resolved quickly with percutaneous surgical release of the hammertoe deformity. Includes video depicting the procedure.
  • Webinar: Transforming Best Practice in Wound Care with Telehealth
    Sign up for a Free Basic Account and watch this webinar produced by WoundReference and presented on Wounds Research.  Click HERE to watch the webinar  Patient Education - Successful TeleVisits For People With Wounds
    Free patient education brochures (handouts) for successful televisits (also known as video visits, telehealth encounter, telemedicine, virtual visits)
  • The Skin
    This topic provides a practical overview of the main cell types and structures of each layer, including stem cells, appendages and nerves and their role in wound healing.
  • Principles of Wound Healing
    Understanding how wound healing occurs or why the process is impaired is essential. This topic reviews principles of wound healing and provides an update on wounds from various perspectives - economic, physiological and pathological. It includes an overview of the different wound types (e.g. acute and chronic, partial and full-thickness, etc), wound healing phases, pathophysiology of chronic wounds, biofilm, and pathological scarring.
  • A Peek Into 2021 - CMS Proposals and Implications for Wound Care Programs
    In August 2020, the Centers for Medicare and Medicaid published two proposed rules for the calendar year (CY) 2021 with provisions that may be of interest to wound care programs and clinicians.
  • How to Assess a Patient with Chronic Wounds
    Treat the cause IV  a. Determine if there is adequate blood supply to heal  b.  Identify the cause(s) as specifically as possible or make appropriate referrals c.  Review cofactors/comorbidities (systemic disease, nutrition, medications) that may delay or inhibit healing  d.  Evaluate the person’s ability to heal: healable, maintenance, non-healable   2a. Develop an individualized plan of care IV b. Treat the ca
  • Arterial Ulcer - Introduction and Assessment
    Evidence-based review on arterial ulcer. Framework for assessment of patients with arterial ulcers. Includes concise abstract and comprehensive resources on the condition (e.g. epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding)
  • Arterial Ulcer - Surgical Treatment
    This topic covers surgical management of arterial ulcers (AUs) with focus on surgical indications and selection criteria.
  • Arterial Ulcer - Treatment
    Concise Algorithm for Assessment of Arterial Ulcer for use at point-of-care. Comprehensive topic including epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding. Free Abstract Summary
  • Patient Education - Arterial Ulcer
    Arterial Ulcers for patients and caregivers. The topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Cutaneous Manifestations Associated With COVID-19
    This topic provides a review on the available knowledge on cutaneous manifestations associated with COVID-19, based on literature review and on data published by the international registry from the American Academy of Dermatology and International League of Dermatological Societies.
  • Webinar: Adding Patient-Centered Telehealth to Your Wound Care Practice
    Are you considering telehealth for your wound practice? If you already use telehealth, have you ever wondered if you are maximizing its potential? MidAmerica Wound Healing Society and Wound Reference invite you to get the latest in telehealth for wound care. Boost your practice by attending this session!
  • Coding and Billing Essentials in Wound Care
    In the U.S., it is estimated that about US$ 32 billion are spent on chronic wounds per year.[1] Patients with chronic wounds frequently receive care at different settings across the continuum of care. Coverage policies and documentation requirements not only are frequently updated, but also vary according to the reimbursement model in each of those care settings. This topic provides an overview of wound care coding, coverage and reimbursement for wound care providers and revenue cycle management professionals. To help achieve optimal reimbursement, frequent access to the most common aspects of billing and coding for wound care provided in this topic is highly encouraged.
  • Provider Supervision of HBOT
    Do physicians need to directly supervise hyperbaric oxygen therapy services (HBOT)? It is helpful to first review the definitions of the different types of level of supervision (CFR Title 42, Chapter IV, Part 410) (i) General supervision means the procedure is furnished under the physician's overall direction and control, but the physician's pre
  • Telehealth in Wound Care - Evidence and Best Practices
    Telehealth has become an important tool in the management of chronic wounds. This topic explains the differences among telehealth modalities and their indications, provides evidence-based recommendations, and summarizes best practices and tips for telehealth in wound care.
  • Staffing, Productivity and Acuity Tool for Wound Care and HBOT Centers
    INTRODUCTIONOverviewBenchmarking tools may help understand staffing needs for each center. The staffing tool created by Larson-Lohr for wound care and hyperbaric medicine centers incorporates elements of both patient acuity and staff productivity and provides suggestions on number of full-time employees (FTEs), more specifically nurses, to cover patient demand in a wound and hyperbaric center.
  • Office/Outpatient Evaluation and Management (E/M) Services for Wound Care and HBOT
    As of January 1, 2021, evaluation and management (E/M) CPT® codes 99202-99215 can be selected on the basis of the complexity of the medical decision making (MDM) or on the basis of the total time on the date of the encounter. This topic provides a summary of the main updates, along with a printable point-of-care tool that includes sample verbiage for support documentation of MDM in wound care and hyperbaric and oxygen therapy (HBOT).
  • Wound Care Basics Part 1. Assessing and Diagnosing Pressure Ulcers/Injuries
    Wound Care Basics Series Part 1 Pressure Ulcers/Injuries
  • How to Perform An Ankle Brachial Index
    DEFINITION Resting ankle–brachial index (ABI) is the most commonly used test in screening for and detection of PAD in clinical settings. The ankle brachial index (ABI) is the ratio between the blood pressure in the ankles and the blood pressure in the arms. Blockage in the arteries of the legs causes less blood flow to reach the ankles. This reduces the blood pressure in the ankle. The ankle brachial index is lower as peripheral artery disease is worse.  The severity of peripher
  • Wound Care Basics Part 2. Managing Chronic Wounds
    Wound Care Basics Series Part 1 Pressure Ulcers/Injuries
  • Prohibited Item Risk Assessment
    Introduction Why should each hyperbaric unit have a prohibited items assessment/checklist? The unit safety program is the foundation of every hyperbaric medicine service. The safety program provides guidance in order to ensure that the risks and hazards associated with hyperbaric oxygen therapy are identified and eliminated. In certain circumstances, the risk can not be eliminated (e.g., removing a wound care product), and mitigating measures must be taken to reduce the risk potentia
  • How to Assess HBOT Prohibited Items: The Go/No-Go Risk Assessment Tool And The Burman Scoring System
    The NFPA recommends that hyperbaric facilities utilize the NFPA Risk Assessment Algorithm for assessment of dressings and items that have not been evaluated or deemed safe for use in the hyperbaric chamber. However, several challenges (as described above) prevent widespread use of the NFPA Risk Assessment Algorithm. The Go No-Go Risk Assessment Tool combines the NFPA Risk Assessment Algorithm and the Burman Risk Scoring System. This combination of the two approaches and a user friendly digital interface provide the hyperbaric facility with a robust go/ no-go documentation and risk mitigation tool. This topic provides step-by-step instructions on how to conduct this risk assessment process.
  • Chronic Wounds Essentials - Quick Reference
    Quick Reference Tool Chronic Wounds - The Essentials (Assessment). Printable.
  • How to Screen, Assess and Manage Nutrition in Patients with Wounds
    Nutrition plays a major role in wound healing. The main goal of nutrition in wound healing is to provide optimum calories and nutrition to support healing. [1][2] Deficiencies in protein, vitamin D, vitamin C and zinc have been demonstrated to impair wound healing, and are often present among patients with chronic wounds. This topic aims to provide practical guidance to support clinical decisions when screening, assessing and managing nutrition in patients with chronic wounds.
  • Applying the Balanced Scorecard in Wound Management and Hyperbaric Medicine
    Guidance on strategic planning and performance improvement tailored to wound care and hyperbaric oxygen therapy (HBOT) programs is still scarce. This topic provides an Editable Balanced Scorecard Tool with sample metrics for wound care and HBOT programs. Institutions can make a copy of the tool, and use it to select and monitor their own objectives and metrics, according to their own vision and mission.
  • Patient Education - Skin Tear
    Skin tears for patients and caregivers. The topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • How to Collect a Wound Swab (Levine Technique) for Culture
    This topic provides the steps for collecting a superficial wound swab for wound culture and susceptibilities (C&S) when there is a suspected wound infection.
  • Wound Culture - Swabs, Biopsies, Needle Aspiration
    ABSTRACTCLINICALOverviewWound infection has been regarded as the one of the most important causes of delayed healing of chronic wounds.[1] On the other hand, overuse and inappropriate use of antibiotics and/or topical antimicrobial agents on non-
  • How to Perform a Wound Biopsy
    A number of wounds are misdiagnosed every year, leading to delayed treatment. Performing a skin biopsy is a simple skill that once learned, can greatly help with the diagnosis of chronic wounds. This topic provides an overview of the different available techniques for wound biopsy, along with a step-by-step protocol for conducting a punch biopsy.
  • Patient Education - Pressure Ulcers/ Injuries
    Pressure ulcers/ injuries for patients and caregivers. The topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Patient Education - Pyoderma Gangrenosum
    Pyoderma gangrenosum for patients and caregivers. The topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Building a Limb Preservation Program: Traditional and Nontraditional Models
    The literature shows that the vast majority of non-traumatic amputations are preventable. The ultimate goal of limb preservation programs is to restore pulsatile blood flow to an at-risk extremity and prevent major lower extremity amputation. This topic provides resources for starting or further developing a limb preservation program.
  • Building a Limb Preservation Program: Challenges and Successes
    INTRODUCTION
  • Skin Failure - Introduction and Assessment
    This topic provides decision support on identification of manifestations of skin failure such as Kennedy terminal ulcers (KTU), Skin Changes At Life’s End (SCALE), Trombley-Brennan terminal tissue injuries (TB-TTI), pressure ulcer/injury (PU/PI) and other conditions.
  • Antimicrobial Stewardship In Wound Care
    INTRODUCTIONOverviewThe inappropriate use of antimicrobial medications contributes to antibiotic resistance and adverse drug events, and improving antimicrobial prescribing practices is a patient safety priority.[1] The Centers for Disease Control and Prevention (CDC) estimates that annually at least 2 million illnesses and 23,000 deaths are caused by antibiotic-resistant bacteria in the United Stat
  • Wound Infection - Guidelines and Quality Measures
    Acute Burn Injury overview: evidence-based clinical guidelines, quality measures and resources
  • Understanding the NFPA 99 Chapter 14 Hyperbaric Facilities: Administration and Maintenance Part 1
    INTRODUCTIONOverviewThe review of NFPA 99 Chapter 14 is intended to provide insight as to how it relates to daily hyperbaric operations, as this chapter applies to all hyperbaric facilities regardless of occupancy (Class A, Class B or Class C). Regulatory/accrediting agencies (FDA/ UHMS) and Authorities Having Jurisdiction (AHJ) reference NFPA 99 chapter to set hyperbaric operational criteria). The 2012 edition of the National Fire Protection Association (NFPA) H
  • How to Apply and Remove a Total Contact Cast
    Practical guidance with step-by-step pictures, protocol and tips on how to apply different types of cellular and/or tissue products (CTPs), also known as skin substitutes
  • Helping People in Ukraine
    We have personally donated to charities supporting people in Ukraine. Would you like to help Ukraine as well? Here is a list of top charities assembled by our editors: UNICEF UkraineAmericares Foundation
  • How to Select and Apply Negative Pressure Wound Therapy Devices
    This topic provides practical guidance to wound care clinicians on the selection of Negative Pressure Wound Therapy (NPWT) devices, device application with step-by-step pictures, assessment of therapy effectiveness, and troubleshooting.
  • Patient Education - Skin Tear (Spanish)
  • Patient Education - Arterial Ulcer (Spanish)
    ¿QUÉ es una úlcera arterial?Las Úlceras arteriales o isquémicas, son una herida o abertura en la piel debido a la mala circulación sanguínea debido a arterias estrechadas o dañadas (insuficiencia arterial). Las úlceras comúnmente ocurren a lo largo de las piernas, los pies o los dedos de los pies.¿QUÉ causa una úlcera arterial?La Enfermedad arterial periférica (PAD) causa la mayoría de las úlceras arteriales. La PAD comúnmente ocurre en pacientes con diabetes mellitus
  • Patient education - Lymphedema (Spanish)
    ¿QUÉ es la linfedema?La linfedema es la acumulación de líquido en partes de su cuerpo, debido a un problema con su sistema linfático. Si el sistema linfático está dañado o bloqueado, se acumulará líquido y causará hinchazón (Figura 1). El sistema linfático es una red de diminutos vasos que actúa como una esponja que extrae líquido de los tejidos y lo dirige de vuelta a la circulación. Si la "esponja" no funciona correctamente, se acumula líquido "impuro", su
  • Patient Education - Nutrition for Wound Healing : Understanding the Basics (Spanish)
    ¿POR QUÉ es importante para mí comer bien cuando tengo una herida?Uno de los aspectos de la cicatrización de heridas que se suele pasar por alto tiene que ver con lo que come, esa es su “nutrición”. El término “nutrición” puede ser tan simple como “el proceso de obtención de alimentos para la salud y el crecimiento”. Sin embargo, la dieta específica que cada persona necesita es única. Hay mucha información sobre la nutrición, pero ¿cómo saber qué es lo mejor para usted?Su cuer
  • Patient Education - Pressure Ulcers/ Injuries (Spanish)
  • Patient Education - Pyoderma Gangrenosum (Spanish)
  • Patient Education - Radiation-induced cutaneous damage - Acute Effects (Spanish)
  • Patient Education - Radiation-induced cutaneous damage - Late Effects (Spanish)
  • Lymphedema - Assessment and Management FAQ
    Wound Care Basics Series Part 1 Pressure Ulcers/Injuries
  • How to Administer Local Anesthesia for Wound Care Procedures
    This topic provides the steps for collecting a superficial wound swab for wound culture and susceptibilities (C&S) when there is a suspected wound infection.
  • Atypical Ulcers
    Algorithm NeoplasticPrimary skin cancer: basal cell carcinoma Primary skin cancer: squamous cell carcinomas Primary skin cancer: malignant melanomas Malignant Fungating Wounds Soft tissue sarcomas in skinKaposisInflammatory: Small/medium/large vesselInflamma
  • Medical Ethics In Wound Care
    ABSTRACTINTRODUCTIONOverviewasdBackground DefinitionsMedical ethics: medical ethics applies moral principles to the solving of dilemmas A
  • An Introduction to Evidence-based Practice in Wound Care
    INTRODUCTIONOverviewBackgroundDefinitionsRelevanceGRADE APPROACH
  • Wound Care Patient Discharge Checklist
    INTRODUCTION"An evidence-based hospital discharge checklist that starts at admission might improve safe transition from hospital to home." REF The sample checklist below was created by a multidisciplinary consensus panel of experts (in acute, chronic, home, and long-term care and in rehabilitation medicine). It may be adapted to each organization Policies and Procedures, and completed during a typical hospitalization. DISCHARGE CHECKLIST
  • Surgical Wound Complications
    Abstract We will write the summary section once topic is completeINTRODUCTIONOverviewwerBackgroundDefinitions: what is a surgical woundRelevanceExplain the importance of this condition. What is the social, financial burden? Surgical wound healing process: primary (closed), secondary (open), tertiary intentionCDC surgical wound classification- clean, clean contaminated, contaminated,
  • Ostomy Care Basics
    Wound Care Basics Series Part 1 Pressure Ulcers/Injuries
  • Applied Anatomy and Physiology in Wound Care
    INTRODUCTIONMusculoskeletal SystemFig. 1. Positions prone to pressure and bony structures involvedRelated topicsPressure Ulcers/Injuries - Overview
  • Gas Laws And The Therapeutic Effects of HBOT
    History Boyle’s, Dalton’s and Henry’s law have significant implications in the use of hyperbaric oxygen therapy. As gases are compressible, they are subject to three inter-related factors: volume, pressure, and temperature. [7] The first documented usage of hyperbaric medical therapy was in 1662. A British physician created the "domicilium" which consisted of a pressurized airtight chamber in which pressure could be increased using a bellows. Numerous aff
  • Skin Substitutes - What's New in 2023? Are Major Updates Coming Up?
    J. Payment for Skin Substituteshttps://www.federalregister.gov/d/2022-14562/p-10281. BackgroundIn the CY 2022 PFS final rule, we finalized an approach for payment of synthetic skin substitutes in the physician office setting. We also announced that we had established a unique HCPCS code for each of ten products for which we had received a HCPCS Level II coding application, and we finalized that those products would be payable in the physician off
  • Fire Triangle/ Tetrahedron and Fire Extinguisher Classification
    A fire extinguisher is an item that hyperbaric personnel rarely think about until needed or asked about during an inspection or site visit. Choosing the correct extinguisher type for a specific fire or for purchasing can be made simple by reviewing a few basic concepts.
  • Patient Education - Foot Care Guide For People With Diabetes Mellitus
    Diabetic Foot Ulcers for patients and caregivers. The topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Patient Education - Foot Care Guide For People With Diabetes Mellitus (Spanish)
    Diabetic Foot Ulcers for patients and caregivers. The topic can be shared by email, or the attached trifold brochure can be printed and handed directly to patients.
  • Patient Education - Acute Burns
    Summary A diabetic foot ulcer is a wound or opening in the skin anywhere on the foot (including toes) of a person with diabetes mellitus (that is, with too much sugar in the blood). Diabetic foot ulcers are serious and can lead to more health problems if not cared for properly. Two out of three amputations in the United States happen because of diabetic foot ulcers. Three out of four people who
  • Patient Education - Acute Burns (Spanish)
    Summary A diabetic foot ulcer is a wound or opening in the skin anywhere on the foot (including toes) of a person with diabetes mellitus (that is, with too much sugar in the blood). Diabetic foot ulcers are serious and can lead to more health problems if not cared for properly. Two out of three amputations in the United States happen because of diabetic foot ulcers. Three out of four people who
  • Pressure Ulcers/Injuries (Spanish)
    Wound Care Basics Series Part 1 Pressure Ulcers/Injuries
  • Standard of Care: Foundations for Wound Management
    Standard of Care: The Foundation of Wound Care The standard of care is a diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. In other words, this is the level of care widely accepted in the medical community. (1) In the wound community, we are quite familiar with the term standard of care as it was
  • Skin Substitutes - What's New in 2024? Preparing for a Phased Approach
    Summary on the current status of CMS regulations involving payment for skin substitutes/CTPs and HCPCS Level II Coding in 2024, grouped by relevance to Physician/ qualified healthcare professional (QHP) offices and hospital outpatient departments (HOPDs):
  • How to Perform Incision and Drainage for Skin and Soft Tissue Abscesses
    This topic provides the steps for collecting a superficial wound swab for wound culture and susceptibilities (C&S) when there is a suspected wound infection.
  • Supervision of HBOT by Providers - Overview
    INTRODUCTIONOverviewThe following hyperbaric medicine treatment protocol is based upon the recommendations of the Hyperbaric Oxygen Committee of the Undersea and Hyperbaric Medical Society. Clinical protocols and/or practice guidelines are systematically developed statements that help physicians, other practitioners, case managers and clients make decisions about appropriate health care for specific clinical circumstances.  
  • ICD-10 Coding in HBOT
    Hyperbaric Oxygen Therapy Single and Dual ICD-10 diagnosis codes
  • Bloodborne Pathogens and Biological Hazards Overview
    Bloodborne Pathogen and Biological Hazard
  • Handling Medical Waste
    Handling Medical WasteOverviewHealthcare settings, including hospitals, doctor's offices, dental clinics, blood banks, veterinary clinics, and research labs, produce various kinds of medical waste. As someone working in healthcare, you might encounter these wastes directly in your role, whether you're involved in patient care, housekeeping, maintenance, or other tasks. It's important to note that some medical waste can pose health risks. This training aims to outline the potenti
  • Hazard Communication
    Hazard CommunicationIntroduction Hazard communication is an essential aspect of occupational safety and health to protect workers from potential hazards in the workplace. This encompasses safety practices such as labeling of hazardous chemicals, Safety Data Sheet (SDS) provision and employee training programs. These practices are important parts of keeping a safe working environment. Topic Objectives
  • Personal Protective Equipment (PPE) Overview
    PPE Overview
  • Important Call to Action: Influence Medicare Coverage for Cellular and/or Tissue Based Products
    Urgent Call to Action for the Wound Care Community: Influence Medicare Coverage for Cellular and Tissue Based Products/Skin Substitute GraftsThe Centers for Medicare & Medicaid Services (CMS) has recently announced that the Medicare Administrative Contractors (MACs) issued the collaborative proposed local coverage determination (LCD) “Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers (DFUs) and Venous Leg Ulcers (VLUs)”. The reason
  • Physician Medical Director - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Physician Medical Director - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Physician Medical Director - Wound CareEmployee:Date:Reports to: Status: [   ] Exempt   [   
  • Advanced Practice Provider (NP, CNS, PA) - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Physician - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Non-Physician Provider - Wound CareEmployee:Date: Registered Nurse - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Wound Care Registered Nurse in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Wound Care Regis
  • Manager - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Wound Care Manager in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Wound Care ManagerLocation
  • Wound Care - Job Descriptions
    Hyperbaric Oxygen Therapy Job descriptions and training guidelines
  • Understanding CPT Code 99211: Billing and Documentation Guidance for Wound Care Programs
    CPT® 99211 “NURSING VISIT”- DEFINITION AND CMS REQUIREMENTS CPT® code 99211 Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal.(2)This was part was deleted In January, 2022.  Providers were trying to use 99211 as quick visits with patients, was potentially shortchanging them since 99212 is for s
  • Wound Assessment, Documentation and Photography
    Policy and Procedure: Wound Assessment (manual), Documentation, and Quality Tracking Policy Overview: All wounds will be assessed upon admission or occurrence, at least weekly, with significant changes, and upon transfer or discharge. Procedure: Documentation Parameters: A. Anatomic Location: The specific location of skin breakdown. B. Etiology (Type): The cause or type of skin breakdown. C. Classification: Pressure
  • Wound Management
    Policy and Procedure: Wound Management Policy Overview: A wound treatment plan will be initiated for a patient at the time of admission or upon development of a wound. The patient's treatment plan will be evaluated at least every week thereafter and revised as necessary, based on the principles outlined below. Procedure: A. Establishing Goals: Collaborate with the patient, family, caregivers, and providers to establish realistic goals relate
  • Resources for Wound Care and HBOT Policies and Procedures
    Resources for Wound Care Policies and ProceduresPeriodic reviews of policies should be conducted to ensure it aligns with best practices and any changes in local regulations or standardsWound Care Center OperationsScope of Service
  • Podiatrist - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Podiatrist - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.
  • Physician - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Physician - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Physician - Wound CareEmployee:Date: OASIS and Wound Assessment for Home Health Agencies
    INTRODUCTIONOverviewThis topic provides clarification on the appropriate use of CPT code 99211 for clinicians and billing professionals in wound care. BackgroundEvaluation and management (E/M) CPT® codes were updated in 2021. Since then, providers have been able to select CPT codes 99202-99215 based
  • Chronic Venous Disease - Surgical Management
    ABSTRACTLymphedema is a chronic disease and the goal of lymphedema treatment is to reset patients to a subclinical or latency stage, regardless of their stage at diagnosis. Conservative management of lymphedema
  • Patient Education - Smoking and Wound Healing
    OverviewWe understand that you have a history of smoking, and we want to help you heal as quickly and safely as possible. Here are some important things to know: No bandage or treatment can fix the damage smoking does because healing happens inside your body.Sometimes, insurance companies won't pay for your treatment if you keep smoking.Your wound healing team will be your biggest supporters and will guid
  • Avascular Necrosis (Aseptic Osteonecrosis)
    Hyperbaric oxygen therapy (HBOT) protocol for Idiopathic Sudden Sensorineural Hearing Loss, with evidence-based graded recommendations, sample documentation statements, physician order template, checklists.
  • The Promise and Responsibility of AI in Wound Care: Enhancing Clinical Decision-Making
    Artificial Intelligence (AI) is revolutionizing healthcare, offering unprecedented capabilities that were once confined to the realm of science fiction.
  • Prohibited Items Signage
    OverviewBackground:  Safety is a priority at all times in the hyperbaric environment. Fire prevention is crucial to maintaining safety. Items that have potential to increase risk of fire via off-gassing, sparking, producing static, and/or generating heat when compressed are prohibited inside a hyperbaric chamber. Hyperbaric clinicians and patients should be educated on the prohibited item list. To comply with National Fire Protection Association (NFPA) stan
  • Patient Education - Hyperbaric Oxygen Therapy for Idiopathic Sudden Sensorineural Hearing Loss
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for chronic refractory osteomyelitis can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Ear Exam - Barotrauma
    Barotrauma may occur in patients receiving HBOT is middle-ear barotrauma (MEB). This topic describes assessment and treatment for MEB
  • Improving Wound Care with a Lean Approach
    It is not unusual for several weeks to pass before a patient with a serious wound receives the proper care for that wound.  Every wound care specialist has experienced the following: a patient with ulcer goes to the emergency department (ED), the ED clinician applies a dressing and refers to a minor injury clinic. Minor injury clinic refers to the primary care physician (PCP), the PCP requires a visit for a look and see. PCP sends a request for authorization/ referral to see a
  • Skin Substitutes - What's New in 2025? Key CMS Updates
    Summary on the current status of CMS regulations involving payment for skin substitutes/CTPs and HCPCS Level II Coding in 2024, grouped by relevance to Physician/ qualified healthcare professional (QHP) offices and hospital outpatient departments (HOPDs):
  • HBO Treatment Emerging Indications
    CLINICALOverviewBackgroundDefinitionsHBOT emerging indication:  An HBOT (Hyperbaric Oxygen Therapy) emerging indication is a medical condition or therapeutic use being explored for potential benefit from HBOT but has not yet received formal approval or endorsement from authoritative organizations, such as the Undersea and Hyperbaric Medical Society (UHMS). These indications are supported by early clinical evidence and biological plausibility, suggesting t
  • HBO Treatment Emerging Indication: Long COVID
    ABSTRACTHBO treatment of Long COVID is effective and safe.  It remains the only effective treatment for this diagnosis that can reverse or improve many symptoms across all organ systems and the benefits are long lasting. The mechanisms by which this occurs remain unconfirmed but are thought to be related to the ability of HBO treatment to modulate inflammation, release stem cells from the bone marrow, affect the immune system and mitochondria and re
  • Legal Aspects in Wound Care
    Abstract Legal aspects in wound care are critically relevant to wound care clinicians because lapses in diagnosis, treatment, or documentation can lead to costly malpractice claims, damage professional reputations, and compromise patient safety. In 2023, U.S. medical malpractice payouts exceeded $4.8 billion across 50,404 claims, underscoring the financial and professional stakes for clinicians.(1)
  • Patient Education - Caring For Your Skin After A Wound Has Healed
    Healing Takes Time! Even if your wound looks closed, the inside is still healing. It can take several months for everything to be fully healed. After the wound closes, it still goes through several steps: At first, a scar is active. It often looks red, raised, firm, and thick. Sometimes, this can be mistaken for an infection. Over the next 4–6 weeks, the scar may get a little bigger and more red.
  • Operational Considerations for Glucose Management in Hyperbaric Oxygen Therapy
    Patient Education - Hyperbaric Oxygen Therapy for ISSHL (Spanish)
    Terapia de Oxígeno Hiperbárico para la Pérdida Auditiva Neurosensorial Súbita Idiopática¿Qué es la terapia de oxígeno hiperbárico (TOHB)?La terapia de oxígeno hiperbárica (TOHB) es un tratamiento médico en el que el paciente respira oxígeno puro a presión. Se administra en una cámara y es el tratamiento para diversas afecciones médicas y quirúrgicas. Suele formar parte de un pl
  • Patient Education - Caring For Your Skin After A Wound Has Healed (Spanish)
    Cómo cuidar la piel después que una herida ha sanado¡La curación lleva tiempo!Aunque la herida parezca cerrada, el interior aún está cicatrizando. Puede tardar varios meses en sanar por completo. Una vez cerrada, la herida aún pasa por varias etapas:Al principio, la cicatriz está activa. Suele verse roja, elevada, firme y gruesa. A veces, esto puede confundirse con una infección. Durante las siguientes 4 a 6 semanas, la cicatriz puede agrandarse un p
  • Hyperbaric Patient Grounding
    INTRODUCTIONBackgroundSafety should be the foundation of every hyperbaric oxygen therapy (HBOT) program.  It is known from documented hyperbaric disasters that taking the time and effort to perform safety checks is paramount to the delivery of safe HBOT. REFIn January 2025, there was a monoplace chamber fire in the United States resulting in the death of a 5 year old HBO
  • Patient Education - Hyperbaric Oxygen Therapy For Soft Tissue Radiation Injury: Cystitis
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for compromised grafts and flaps can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy For Soft Tissue Radiation Injury: Proctitis
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for compromised grafts and flaps can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Incontinence Associated Dermatitis - Introduction and Assessment
    Incontinence‐associated dermatitis (IAD) is an irritant contact dermatitis from prolonged contact with urine or feces, which can significantly impact patient comfort and quality of life. This topic provides an introduction and framework for assessment of incontinence associated dermatitis (IAD), including epidemiology, risk factors, etiology, pathophysiology, history, physical examination, diagnosis, differential diagnoses, documentation and ICD-10 coding.
  • Incontinence Associated Dermatitis - Prevention and Management in Adults and Older Adults
    Incontinence‐associated dermatitis (IAD) is an irritant contact dermatitis from prolonged contact with urine or feces, which can significantly impact patient comfort and quality of life. [1][2][3] IAD is one of the four clinical types of moisture-associated skin damage (MASD) and is considered preventable.[4] This topic covers management and prevention of incontinence associated dermatitis (IAD) for the adult and older adult population.
  • Skin Substitutes - What’s New in 2026? Navigating CMS Payment Changes
    On October 31 2025, the Centers for Medicare & Medicaid Services (CMS)  finalized several updates for Skin Substitute payment and coding taking effect January 1, 2026. These changes mark significant shifts in years for wound care clinicians, billing teams, and product manufacturers.CMS’ key policy objectives driving updates include:  (1) to ensure a consistent payment approach for skin substitute products across the physician office and hospital out
  • The Path to Zero Avoidable HAPI: System-Wide Strategies To Prevent Pressure Ulcers/Injuries
    Discover how hospitals can achieve Zero HAPIs (hospital-acquired pressure injuries) through system-wide prevention strategies, evidence-based education, and digital competency programs. This article features a real-world case study in which a multi-site health system improved nurse knowledge by 25% and reached Zero Stage 3–4 HAPIs within one year.
  • Incontinence Associated Dermatitis - Prevention and Management in Newborns and Infants
    Incontinence‐associated dermatitis (IAD) is an irritant contact dermatitis from prolonged contact with urine or feces, which can significantly impact patient comfort and quality of life. This topic covers management and prevention of incontinence associated dermatitis (IAD) in newborns and infants.
  • Pediatric Wound Management: Assessment, Treatment, and Prevention
    Evidence-based guidance for assessing and managing pediatric wounds, including risk factors, treatment strategies, and age-specific considerations.
  • Interprofessional Education in Wound Care - Bridging the Knowledge Gap
    Bridging the Knowledge Gap: The Power of Interprofessional Education in Wound CareIn the complex and ever-evolving field of wound care, achieving optimal patient outcomes is a team effort. A single clinician, no matter how skilled, cannot manage a patient’s comprehensive wound care needs alone. This is why the ability to educate interprofessional team members is a cornerstone of advanced wound care practice - a vital skill recognized in wound care certification examsWhat is I
  • Wound Care Analytics: Using Data to Drive Evidence-Based Practice
    Wound Care Analytics: Using Data to Drive Evidence-Based PracticeCollecting and analyzing wound care data transforms routine clinical observations into measurable outcomes that drive evidence-based decisions, identify practice gaps, and benchmark performance against standards.REF  REF Tracking wound prevalence and incidence enables teams to evaluate prevention effectiveness, determine healing efficiency, and allocate resources strategically to impro
  • Culturally and Linguistically Appropriate Services in Wound Care
    Successful outcomes in wound care depend on aligned partnerships with patients and caregivers. Clear, language-concordant communication is essential to support understanding, reinforce self-care responsibilities, and enhance adherence. The Joint Commission’s patient-centered communication standards require organizations to identify and address individual communication needs, including preferred language and health literacy barriers. These expectations align closely with the National Culturally and Linguistically Appropriate Services (CLAS) Standards, which emphasize structured language access and culturally responsive care as foundational components of safe, high-quality practice. This topic provides an overview of CLAS principles applied to wound care.
  • 2026 CMS Rules for Skin Substitutes: Billing, Payment & Coverage FAQ
    On October 31 2025, the Centers for Medicare & Medicaid Services (CMS)  finalized several updates for Skin Substitute payment and coding taking effect January 1, 2026. These changes mark significant shifts in years for wound care clinicians, billing teams, and product manufacturers.CMS’ key policy objectives driving updates include:  (1) to ensure a consistent payment approach for skin substitute products across the physician office and hospital out
  • Mobile Wound Care at Scale: The Role of Standardization, Data, and Decision Support
    Coming soon...
  • Policy and Procedure: Pressure Injury Assessment, Treatment, and Prevention
    Pressure Injury:  Assessment, Treatment, and PreventionPURPOSE:In-Patient: To identify the process for assessing patient risk for skin breakdown using the Braden Scale for Predicting Pressure Injury Risk, identifying other risk factors, developing and implementing appropriate interventions based on the score obtained and risk factors identified, and initiate treatment and management of skin impairment.Out-Patient: Revie
  • Patient Education - HBOT Multiplace Chamber
    What is Hyperbaric Oxygen Therapy?Hyperbaric oxygen is a medical treatment in which the patient breathes pure oxygen under increased pressure. It is administered in a multi person chamber and is the treatment for many medical and surgical conditions. It may be the main treatment for certain conditions but is usually part of an overall plan of care involving surgery, antibiotics or other therapy.Hyperbaric oxygen is a simple concept. The air we breathe is normally 2
  • Patient Education - HBOT Multiplace Chamber Patient Guide
    OVERVIEWHyperbaric Oxygen Therapy (HBOT) is a non-invasive painless mode of therapy. A patient receiving HBOT breathes 100% oxygen, at a pressure greater than sea level, while in an enclosed medically certified pressure vessel. This results in a dramatic elevation of oxygen in the blood, tissue and body fluids. HBOT can result in blood oxygen levels 15 times greater than blood oxygen levels in normobaric conditions.  Learn more about hyperbaric oxygen therapy (see topic "What is
  • CMS March 12, 2026 Update: Corrections to Skin Substitute Coding & Payment Under the PFS
    CMS March 12, 2026 Update: Critical Corrections to Skin Substitute Coding & Payment Under the PFSCMS has issued a March 12, 2026 correction to the CY 2026 Physician Fee Schedule (PFS), updating Addendum B to address multiple misclassified skin substitute HCPCS codes.While these changes may appear technical, they have immediate implications for reimbursement, claim accuracy, and audit risk for wound care and hyperbaric programs.Why this
  • Multiplace Routine Inspection - Daily Chamber
    Hyperbaric Oxygen chamber daily inspection rationale and template.
  • Patient Education - Hyperbaric Oxygen Therapy for Soft Tissue Radiation Injury: Cystitis (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for compromised skin grafts and flaps can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Soft Tissue Radiation Injury: Proctitis (Spanish)
    TERAPIA DE OXÍGENO HIPERBÁRICO PARA LESIONES POR RADIACIÓN EN TEJIDOS BLANDOS: CISTITIS   Foll
  • Cellular and/or Tissue Based Products - Evidence Guide for Non-DFU/Non-VLU Wounds
    Purpose: Support medical necessity documentation using clear descriptions of the type of published evidence available for each product and indication.Evidence descriptions reflect the type of published data (e.g., comparative studies, cohorts, case series, case reports) to support accurate, audit-ready documentation.1. CHRONIC WOUNDS (NON-DFU/VLU)Pressure Ulcers/Injury Prevention - Documentation Templates and Order Sets for Staff Nurses
    EMR Template: Wound Assessment for Staff NursesINSTRUCTIONS FOR TEMPLATE USE AND ADAPTATIONGoal and AudienceThis electronic medical record (EMR) Template for Wound Assessment is designed for use by Staff Nurses (or equivalent clinical personnel) to standardize the documentation of wound assessments. Healthcare organizations are encouraged to adapt, modify, and customize this template to align with their specific facility policies, EMR system capabilities, and workflow req

    Sign up to Message

    Sign up for a Free Basic account to message this specialist.

    Sign Up
    WoundReference logo
    San Francisco, CA
    Schedule Meeting
    ©2026 Wound Reference Inc.

    Basic Navigation

    Feature Navigation

    Solutions

    Individuals:
    Institutions:
    Special Features:
    t -->