Attend a Webinar

Negative Pressure Wound Therapy

Coverage

Documentation

Reviews/Audits

  • Medical Review - View notifications/findings of pre/post claim reviews completed by Noridian Medical Review

Tips

Billing Exclusions

A NPWT pump and supplies will be denied as not reasonable and necessary if one or more of the following are present:

  • The presence in the wound of necrotic tissue with eschar if debridement has not been attempted.
  • Osteomyelitis within the vicinity of the wound that is not concurrently being treated with intent to cure.
  • Cancer present in the wound.
  • The presence of an open fistula to an organ or body cavity within the vicinity of the wound.

Negative Pressure Wound Therapy (NPWT) Continued Coverage

For qualifying wounds coverage to continue, a licensed medical professional must do the following:

  • On a regular basis,
    1. Directly assess the wound(s) being treated with the NPWT pump, and
    2. Supervise or directly perform the NPWT dressing changes, and
  • On at least a monthly basis, document changes in the ulcer's dimensions and characteristics.

If this criterion is not fulfilled, continued coverage of the NPWT pump and supplies will be denied as not reasonable and necessary.

Last Updated Sep 06 , 2024

Related Articles

paginationType noridian
Articles Source Posted
Negative Pressure Wound Therapy Webinar - 10/23/2024 09/17/2024
Negative Pressure Wound Therapy DME on Demands 07/09/2024
Negative Pressure Wound Therapy Pumps Policy Specific Requirements 01/25/2024
LCD and Policy Article Revisions Summary for December 14, 2023 12/14/2023
Qualifying for Continued Coverage of Negative Pressure Wound Therapy (NPWT) 08/24/2023
Negative Pressure Wound Therapy Webpage Features Tips and Tools 07/21/2023
Documentation Checklist for Negative Pressure Wound Therapy 05/23/2023
Supplies for Negative Pressure Wound Therapy (NPWT) Pumps 04/11/2023
Negative Pressure Wound Therapy (NPWT) Continued Coverage 05/19/2022