Supplies for Negative Pressure Wound Therapy (NPWT) Pumps

  • Coverage is provided up to a maximum of 15 dressing kits (A6550) per wound per month.
  • Coverage is provided up to a maximum of ten canister sets (A7000) per month unless there is documentation evidencing a large volume of drainage (greater than 90 ml of exudate per day).
  • For high volume exudative wounds, a stationary pump with the largest capacity canister must be used.
  • When billing for quantities of canisters greater than those described in the policy as the usual maximum amounts, there must be clear and explicit information in the medical record that justifies the additional quantities.

This information can be found in the Negative Pressure Wound Therapy Pumps Local Coverage Determination (LCD) L33821.

 

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