Preliminary Decision By CMS Keeps NPWT Devices In One Code

Full article reprinted from "The Gray Sheet" - June 15, 2009

CMS is proposing to keep negative pressure wound therapy devices in one Healthcare Common Procedure Coding System code, in line with recommendations from the Agency for Healthcare Research and Quality. Read more...

Preliminary Decision By CMS Keeps NPWT Devices In One Code

Full article reprinted from "The Gray Sheet" - June 15, 2009

CMS is proposing to keep negative pressure wound therapy devices in one Healthcare Common Procedure Coding System code, in line with recommendations from the Agency for Healthcare Research and Quality.

The agency released its preliminary coding decision June 9, in advance of a July public meeting on the matter. CMS will announce a final decision on NPWT codes in November.

A recent AHRQ draft technology assessment found there were no studies that directly compared one type of NPWT system with another, or that showed any differences between systems in wound healing outcomes ('The Gray Sheet' April 20, 2009, p. 19).

At CMS' request, AHRQ had examined information submitted by manufacturers including market leader Kinetic Concepts ( V.A.C. ), Smith & Nephew ( Versatile 1 and VISTA Versatile 1 ), Medela ( Vario ) and ConvaTec ( Engenex ).

A final assessment dated May 26 upholds AHRQ's original conclusion that all NPWT devices should remain in the same code.

The upcoming CMS meeting July 9 on AHRQ's findings and NPWT coding will give Kinetic Concepts another opportunity to plead its case for a distinct code for its V.A.C. system.

The company has argued that V.A.C. should be coded separately from other negative pressure wound therapies because it is clinically superior and carries a higher price tag.

Smith & Nephew, which also markets the Renasys NPWT system, claims that keeping the devices in one code levels the playing field among manufacturers. A single code also facilitates physician choice, said Tom Dugan, president, North America, S&N Wound Management.

Medicare reimbursement for NPWT has come under increased scrutiny in recent years. HHS' Office of Inspector General has issued two separate reports warning that Medicare is significantly overpaying for the devices, and urging CMS action to curb payment.

- Brooke McManus

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