V.A.C. Therapy Reimbursement
As a value added service to our customers, KCI provides resources to help answer questions related to coding, coverage and reimbursement for V.A.C.® Therapy products. Many tools and resources are available on this site to assist you:
- Reimbursement Hotline
- Payor Systems
- Coding
- Product Reimbursement
- NPWT Coverage and Medical Policies
- Useful Links & Resources
Disclaimer: The information provided by KCI is general reimbursement information only. It is not legal advice, nor is it advice about how to code, complete or submit any particular claim for payment. Although we supply this information for your convenience, it is the provider’s responsibility to determine and submit appropriate codes, charges, modifiers, and bills for services rendered. Payors or their regional offices may have their own coding and reimbursement requirements and policies. Before filing any claims, providers should verify current requirements and policies with the payor.
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Reimbursement Hotline
KCI is committed to providing customer service to clinical providers and healthcare facilities that use KCI products, including product reimbursement resources.
The Reimbursement Education Hotline is staffed by reimbursement specialists to offer assistance with the following:
- Coding
- Published Coverage Guidelines
- Reimbursement Information
KCI Reimbursement Education Hotline is available from Monday to Friday, 8 a.m. – 8 p.m., EST
Tel: 800-668-6812
Fax: 800-311-9291
Email: ReimbursementEducation@KCI1.com -
Payor Systems
KCI has provided the following information related to payor systems and understanding reimbursement for Negative Pressure Wound Therapy (NPWT) products and services.
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Coding
Developed by the Centers for Medicare and Medicaid Services (CMS), the Health Common Procedural Coding System (HCPCS) provides a standardized system for billing Medicare for supplies, materials and injections. HCPCS consists of two levels which can be used to bill for professional services and medical device supplies and materials.
Source:
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Product Reimbursement
The following information will assist you in understanding Medicare coverage and reimbursement along with what NPWT products are available by care setting.
This chart identifies the Medicare coverage and Negative Pressure Wound Therapy (NPWT) reimbursement by care setting.
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NPWT Coverage and Medical Policies
CMS and private payers develop medical policies and coverage criteria that outline requirements that must be met prior to services being authorized.
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Useful Links & Resources
- CMS Programs and Information: http://www.cms.gov/default.asp
- CMS Local Coverage Determinations (LCD): http://www.cms.gov/MedicareContractingReform/08_DurableMedicalEquipmentMedicareAdministrativeContractor.asp#TopOfPage
- Medicare Payment Advisory Commission (MedPac): http://www.medpac.gov/
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