The Amerian Medical Association will be issuing several new reimbursement (CPT) codes. The American Collge of Surgeons is working with AMA to assign appropriate “Relative Values” to those codes. Any phsician or surgeon who debrides complicated wounds and wishes to assist in this process should participate in their survey. More information can be found BELOW.
The Amerian Medical Association will be issuing several new reimbursement (CPT) codes. The American Collge of Surgeons is working with AMA to assign appropriate “Relative Values” to those codes. Any phsician or surgeon who debrides complicated wounds and wishes to assist in this process should participate in their survey. More information can be found BELOW.
If one of your methods for debriding complicated wounds is maggot debridement therapy, then we suggest that you inform the American College of Surgeons and/or the Wound Healing Society (or whatever professional organization best represents and advocates for you) that maggot therapy is not appropriately nor adequately coded by any of these new or currently existing codes. A draft letter and the addresses to these organizations can be found BELOW.
ACS NewsScope
A Weekly News Update from the American College of Surgeons
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December 4, 2009
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INPUT SOUGHT REGARDING NEW CPT DEBRIDEMENT CODES FOR LARGE WOUNDS
The Current Procedural Terminology (CPT) editorial panel has approved three new add-on codes for CPT 2011 to report debridement greater than 20 sq cm. The American College of Surgeons invites surgeons who are familiar with wound/ulcer debridement procedures to complete an American Medical Association/Specialty Society Relative Value Scale Update Committee survey to ensure that the physician work regarding relative value units for these procedures will be accurately and fairly presented to the Centers for Medicare & Medicaid Services.
The deadline to complete the survey is Monday, December 14.
PC users can click on the following link for the online survey:
https://www.formrouter.net/forms@JMMS/110XX-ZZZ-Svy.pdf
Mac users will not be able to complete the survey online. Instead, click on the following link to download a Word version of the survey:
http://www.facs.org/newsscope/ahp/survey/11045.46.47X.doc
After completing the Mac version, e-mail to [email protected].
Please note that the procedure descriptions in the survey have just been approved by CPT and will not be available for reporting until published in the CPT manual. The members of the College’s General Surgery Coding and Reimbursement Committee appreciate your time and effort with this review.
CPT Codes for Maggot Debridement Therapy
If you are a clinician and one of your methods for debriding complicated wounds is maggot debridement therapy, then we suggest that you inform your professional representative organization that maggot therapy is not appropriately nor adequately coded by any of these new or currently existing codes.
If you are a member of the American College of Surgeons, then we suggest that you let the College know that maggot therapy is not appropriately nor adequately coded by any of these new or currently existing codes. Their contact information is:
- Christian Shalgian, Director
Division of Advocacy and Health Policy
American College of Surgeons
633 N Saint Clair Street
Chicago, IL 60611-3211
Phone: 312-202-5000; Toll free: 800-621-4111
Fax: 312-202-5001
E-mail: [email protected]
Contact information for the Wound Healing Society is:
- The Wound Healing Society
341 N. Maitland Ave., Suite 130
Maitland, Florida 32751
Phone: 407-647-8839
E-mail: [email protected]
Contact information for the American Podiatric Medical Association is:
- American Podiatric Medical Association, Inc.
9312 Old Georgetown Road
Bethesda, MD 20814-1621
Phone: 301-571-9200 / 301 581 9200
Fax: 301-530-2752
Your letter could include the following elements:
Dear Sir / Madam:
Thank you for your efforts to improve the coding and reimbursement for debridement of serious wounds.
Unfortunately, one of the methods we commonly use for debridement of serious wounds is maggot therapy. As you know, maggot therapy is a very effective method for debriding problematic wounds, but the application of maggots can be time-consuming, and the consumable dressing materials can be significant.
The newly proposed debridement codes (11042-11044) do not appropriately code for maggot therapy because the depth of debridement is not known until the maggots have completed working several days later. Current coding recommendations (including those suggested in CPT Advisor, September 2008) are not adequate because the cost of maggots and containment dressings are not included in the reimbursement level of those codes (97602), and listing the costs of “supplies and materials provided by the physician over and above those usually included with the office visit” (CPT 99070) is often ignored by 3rd party payers. CMS has publicly stated that they will not issue separate HCPCS product codes for all of those items. Instead, they have repeatedly recommended that AMA issue dedicated codes for maggot debridement therapy.
We hope that you will pass this recommendation on to AMA’s CPT Editorial Panel.
Thank you for your support of quality wound care and fair compensation.
Sincerely,
Etc, Etc,
. . . And Thank You for supporting Biotherapy and the BTER Foundation!