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Alliance of Wound Care Stakeholders Update - Quarter 2

07/05/2019 2:31 PM | Anonymous

Your APWCA recently collaborated with the Alliance of Wound Care Stakeholders and others in an effort to combat an unfair policy from WPS Government Health Administrators. WPS is the Part B Medicare Administrative Contractor (MAC) for Nebraska, Kansas, Iowa, Missouri, Michigan, and Indiana. WPS released the Local Coverage Article, "A55909: Wound Care Coding Companion for Wound Care L37228”. This article excluded coverage for CPT 97597 (Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less) when the depth of the ulcer debrided is limited to breakdown of skin. A letter was written to WPS challenging this exclusion and requesting that WPS provide peer-reviewed literature that supports this exclusion.

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