Negative Pressure Wound Therapy Pumps - Policy Article

NPWT pumps and supplies (E2402, A6550, A7000) are covered under the DME benefit when the LCD reasonable-and-necessary criteria and Medicare requirements are met; NPWT systems must be integrated and pumps must meet specific operational specifications (40–80 mm Hg, continuous/intermittent modes, sensors/alarms). Disposable wound suction systems (A9272) are statutorily noncovered; documentation requirements include detailed baseline and monthly quantitative wound measurements, diagnosis coding to the 5th digit on each claim, and contemporaneous practitioner records to support extensions beyond the standard four-month coverage limit, which can only be granted one month at a time via appeals.

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