V.A.C. Therapy

While V.A.C.^® Therapy may initially seem more expensive, the clinical benefits may actually help facilities lower their overall cost of care. You can learn more about V.A.C. Therapy’s demonstrated cost effectiveness.

Can a hospital bill for V.A.C. Therapy?
Can you treat more than one wound with one therapy unit?
Gauze or foam dressings. Is there a difference?
How do I know if V.A.C. Therapy is appropriate for my patient’s wound?
Is there currently a CPT Code that can be used to bill for application of V.A.C. Dressings?
Is the V.A.C. Dressing change a clean or sterile technique?
V.A.C. Therapy is more expensive than other treatment options – why should I use it?
What’s the difference between the black foam and the white foam?
What’s the difference between V.A.C. Therapy and other NPWT devices?
What’s the difference between V.A.C. Therapy and wound drainage?

Can a hospital bill for V.A.C. Therapy?

Yes, a hospital can include charges for the daily therapy unit rental and dressings and canisters on its bill. The charge is established in the hospital charge description master with an association to the following UB 92 revenue codes:

Daily Unit Rental – UB92 code 947 (medical surgical supplies)
Dressings and canisters – UB92 code 272 (sterile medical surgical supplies)

Can you treat more than one wound with one therapy unit?

Yes. KCI has established two methods for connecting wounds to one therapy unit: “Bridging” and “Y-connecting.”

Bridging can be accomplished when you have multiple wounds of similar pathology in close proximity to one another. The V.A.C.^® drape is placed on the intact skin between wounds, and a strip of foam is placed from one wound bed to the other over the draped skin. As long as all pieces of foam are touching each other, you can place the tubing in a central location and use one pump to distribute pressure throughout all the wounds.

Y-connecting allows you to treat multiple, non-infected wounds that are a larger distance apart by using a connector that can support two separate tubing connections. Negative pressure in either situation is distributed across the wounds, yet controlled by one pump.

Please reference the V.A.C. Therapy Clinical Guidelines for more information.

Gauze or foam dressings. Is there a difference?

Yes, there is a clinical difference. Although the V.A.C.^® GranuFoam™ Dressing (black foam) may seem like simple surgical foam, it has been specifically engineered to deliver NPWT. The hydrophobic, open pore structure of V.A.C. GranuFoam Dressings adapt to the contours of deep or irregularly shaped wounds in order to provide equal distribution of pressure at the wound site. These open pores are also manufactured under specifications to achieve a 400-600 micron pore size to help promote wound healing.

For these reasons, gauze will not provide the proven benefits of NPWT, and, in some cases, the pooling of fluids may occur and interfere with the wound healing process^{11, 14}.

How do I know if V.A.C. Therapy is appropriate for my patient’s wound?

V.A.C.^® Therapy is indicated for a wide range of acute and chronic wounds and is appropriate for use in all care settings. Learn more about V.A.C. Therapy wound types and indications, along with important contraindications and safety information.

Is there currently a CPT Code that can be used to bill for application of V.A.C. Dressings?

Yes. V.A.C.^®Therapy is verified by the Centers for Medicare & Medicaid Services (CMS) to deliver Negative Pressure Wound Therapy (NPWT). Physicians and other healthcare providers treating patients with V.A.C. Therapy may be eligible for reimbursement for services associated with NPWT.

CPT Code	Wound Size	Relative Value Units (RVUs)
97605	≤ 50 cm2 in surface area	0.55
97606	> 50 cm2 in surface area	0.60

The dollar amount of the payment will vary, depending on the geographic location within the US and practice costs within that location.

Source: Current Procedural Terminology 2006 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. The information contained in this document is provided for informational purposes only and represents no statement, promise or guarantee by KCI concerning the levels of reimbursement, payment, calculations, eligibility, charge or that these codes will be appropriate for specific services provided or that reimbursement will be made. KCI recommends that you consult your local CMS contracted carrier or other applicable payer organization with regard to specific reimbursement policies, coverage, payment and criteria. Individual circumstances and situations may vary. Consult the AMA CPT Handbook and the ICD-9 CM coding manual for complete listings and descriptions.

Is the V.A.C. Dressing change a clean or sterile technique?

The decision to use clean versus sterile/aseptic technique is dependent upon wound pathophysiology, physician/clinician preference, and institutional protocol.Dressing applications regarding clean or sterile technique are completely at the preference of the physician/clinician. Disposable components of the V.A.C.^® (Vacuum Assisted Closure Therapy System, including the foam dressing (i.e., V.A.C.^® GranuFoam™, V.A.C.^® GranuFoam Silver^®, or V.A.C.^® WhiteFoam™ Dressing), tubing and drape are packaged sterile and are latex-free. V.A.C. Therapy Unit canisters are packaged sterile or fluid path sterile and are latex-free. A clinician has the option of applying the dressings in the Operating Room utilizing a sterile/aseptic technique if needed. The clinician can also use clean technique for placement in the home setting or for pathologies that do not require sterile technique. As with all dressings that are packaged sterile, the options for use would be those in compliance with the protocols and institutional policies regarding wound care.

V.A.C. Therapy is more expensive than other treatment options – why should I use it?

While V.A.C.^®Therapy may initially seem more expensive, the clinical benefits may actually help facilities lower their overall cost of care. You can learn more about V.A.C. Therapy’s demonstrated cost effectiveness.

What’s the difference between the black foam and the white foam?

The black foam – V.A.C.^® GranuFoam™ Dressing – is hydrophobic or water repelling. The reticulated, open pore foam allows exudate to be removed and enables the dressing to conform to the wound bed providing the foam-tissue interface. This design allows for increased distribution of negative pressure across the wound bed and stimulates tissue formation granulation.

The white foam – V.A.C.^® WhiteFoam™ Dressing – is hydrophilic or moisture retaining. Its higher tensile strength and less adherent properties are typically indicated for use in tunnels and shallow undermining. It is also beneficial for use on exposed hardware and protected exposed tendons and bones.

What’s the difference between V.A.C. Therapy and other NPWT devices?

There is an important difference between V.A.C.^® Therapy and other Negative Pressure Wound Therapy devices that can potentially affect your wound healing outcomes

There is an important difference between V.A.C.^® Therapy and other Negative Pressure Wound Therapy devices that can potentially affect your wound healing outcomes^{20, 5, 1, 3}. Only the V.A.C. Therapy System uses V.A.C.^® GranuFoam™ Dressings in the wound –other NPWT devices typically use gauze dressings.

Under negative pressure, the hydrophobic, reticulated, open pore structure of V.A.C. GranuFoam Dressings creates an environment that promotes wound healing at the cellular level. When negative pressure is applied to the wound bed through the V.A.C. GranuFoam Dressing, mechanical forces stretch cells as tissue is pulled into the open pores of the dressing. The stretching stimulates cellular proliferation, which results in the formation of granulation tissue^{2, 12, 13}.

Because gauze does not have the open pore structures found in the V.A.C. GranuFoam Dressings, gauze has not been shown in bench testing to increase cellular activity, and because of its absorptive nature, gauze may actually interfere with negative pressure delivery and the wound healing process^{11, 14}.

You can learn more about how only V.A.C. Therapy works on the cellular level to promote wound healing.

What’s the difference between V.A.C. Therapy and wound drainage?

Draining fluids from a wound can be an important part of healing. However, it is just one of several mechanisms of V.A.C.^® Therapy. V.A.C. Therapy NPWT is indicated to deliver all of the following mechanisms critical to wound healing:

Prepares wound bed for closure⁹
Reduces edema¹⁰
Promotes granulation tissue formation and perfusion^{2, 12, 13, 19}
Removes exudate¹² and infectious material⁶
Draws wound edges together⁹
Creates an environment that promotes wound healing⁶