CMS maintains status quo on NPWT codes

Wednesday, November 11, 2009

BALTIMORE – There will be no new codes for negative pressure wound therapy (NPWT) products, said CMS, which released its final decision on the matter last week.

In the final decision, released Nov. 3, CMS stated: "There is insufficient data at this time to demonstrate significant (difference) between NPWT products, or any NPWT product component, to justify a separate HCPCS code(s). The existing NPWT codes adequately identify the NPWT products on the market."

Codes for the product category came under review after the Medicare Improvements for Patients and Providers Act (MIPPA), which was passed in July 2008 as part of a delay for national competitive bidding, called for a review of how the products were coded and reimbursed. The codes had not been reviewed since 2005 and many products have been added to the category since. MIPPA also excluded NPWT from Round 1 of the program to allow time for the code review.

In April, CMS and the Agency for Healthcare Research and Quality (AHRQ) released a study that concluded there was no need for additional codes for NPWT products because there are no significant differences between products.

Pump supplier Smith & Nephew applauded the decision.

"We strongly support this decision and believe it is in the best interests of Medicare, physicians and their patients," stated Tom Dugan, North American president for Smith & Nephew in a release.