No New NPWT Codes

BALTIMORE — After the results of a study found no significant differences between negative pressure wound therapy devices — and, therefore, no need for multiple codes — CMS made it official with the release of its final decision on the matter Nov. 3.

The Medicare Improvements for Patients and Providers Act required an evaluation of existing HCPCS codes for NPWT devices “to ensure accurate reporting and billing for the items and services under such codes,” according to the agency, which partnered with the Agency of Healthcare Research and Quality on a review. Following the study, CMS issued a preliminary decision to maintain a single code for NPWT and held a public meeting on the issue July 9.

In its final decision, the agency said it would hold to the current single reimbursement code for NPWT product components, including the canister and wound care set.

According to the decision, CMS “determined that there is insufficient data at this time to demonstrate significant functional distinction or significant therapeutic distinction between NPWT products, or any NPWT product component, to justify a separate HCPCS code(s) … CMS’ conclusion is that the existing NPWT codes adequately identify the NPWT products on the market.”

St. Petersburg, Fla.-based pump distributor Smith & Nephew said it supports the single-code decision. “It is the simplest coding requirement for clinicians and other caregivers, and creates value for their institutions,” said Tom Dugan, North American president, Smith & Nephew Advanced Wound Management, in a release.

View a PDF of CMS’ final decision.

Earlier this year, the Office of Inspector General recommended a reimbursement reduction for NPWT devices.