Cellular and/or tissue-based products (CTPs): Engineered wound dressing products created to promote biological repair or regeneration of wound tissue by providing signaling, structural, or cellular elements with or without systems that contain living tissue or cells. 

Current Procedural Terminology (CPT®) Codes: These codes characterize the procedure performed by a provider and oftentimes in wound care will also indicate anatomic location and size of the wound in question. Codes such as this may be employed, for example, for debridement.

Global period: A global period is a specific time frame that encompasses all services provided related to a procedure performed and billed. Certain components of the surgical package, such as post-operative care, may not be billed separately during a global period.

Healthcare Common Procedure Coding System (HCPCS): Specifically referring to HCPCS Level II, a standardized coding system used to describe products, supplies, and services that do not fall under the umbrella of a CPT code. This may include durable medical equipment or certain supplies. 

International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM): A medical coding system used to identify and describe diseases and symptoms for the purpose of billing and documentation. 

Local Coverage Article (LCA): Medicare Administrative Contractors typically publish these guidelines or education to complement an existing National or Local Coverage Determination, or it may also be an independent policy. 

Local Coverage Determination (LCD): Medicare Administrative Contractors make these decisions regarding coverage of a product or service that will then apply to their specific region of jurisdiction.

Medicare Administrative Contractor (MAC): A regionally based Medicare insurer that processes certain claims for Medicare fee-for-service beneficiaries in their designated geographic area. MACs often have a multi-state jurisdiction and administer many aspects of the Medicare program including claim processing, provider enrollment, audit, reimbursement, establishing LCDs, and reviewing medical records. 

Modifiers: In medical coding, a modifier is 2 letters or numbers that append to another code to provide additional information about the circumstances of the service or product without changing the meaning of the code.

Place of service (POS) code: Acute care hospital, long-term care or rehabilitation hospital, skilled nursing facility, home health agency, physician’s office, outpatient clinic, hospice, assisted living residence, nursing home, or patient’s home are examples of settings that may carry their own unique POS code, which providers should include on their service claim submissions.

Qualified health care professionals (QHP): These providers undergo and achieve training, education, licensing (when applicable), and institutional privileges (when applicable) to perform and report a service within their scope of practice.

Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and payment information is error-free and/or that payment will be received.

Current Procedural Terminology CPT® copyright 2025 American Medical Association. All rights reserved.