Coding decision panned, praised

Monday, August 31, 2009

BALTIMORE - Industry stakeholders at a July 9 meeting on a recent code review of negative pressure wound therapy pumps (NPWT) spoke for and against the findings.

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 (E2402, A700, A6550) because there are no significant differences between products.

Pump supplier KCI contends that there is plenty of evidence to suggest that foam-based NPWT pumps, like its V.A.C. system, have a therapeutic benefit over gauze-based systems.

"In this era of evidence-based medicine, all of the evidence suggests that foam-based NPWT systems have certain characteristics that are tied to better clinical outcomes," said Susan Morris, vice president of health policy for KCI. "There is no evidence that gauze under pressure and foam under pressure work the same way or deliver the same clinical outcomes."

Smith & Nephew, which offers a foam- and gauze-based system, supported the coding decision, said Dr. Doran Edwards, who spoke on behalf of the company. At the meeting he stated: "Smith & Nephew strongly concurs with CMS's preliminary decision to maintain the existing HCPCS codes for NPWT systems."

The decision isn't final, but it paves the way for NPWT to be included in an upcoming round of NCB.

"AAHomecare is concerned that any DME category is included in NCB," said Alexandra Bennewith, senior manager, government affairs. "We believe the program reduces patient access and choice to quality items and services and restricts the number of providers based on price alone." hme