Negative Pressure Wound Therapy/Vacuum Assisted Closure (VAC) for Nonhealing Wounds - (0064)

Powered NPWT/VAC devices (CPT 97605/97606; HCPCS A6550/E2402) are considered medically necessary for nonhealing wounds (chronic ulcers, selected acute/traumatic wounds, grafts/flaps, certain post‑surgical complications), while disposable non‑powered and single‑use battery‑powered NPWT systems (CPT 97607/97608; HCPCS A9272 — e.g., SNaP, PICO, Prevena, V.A.C. Via, MyNeWT, Uno) are explicitly excluded for any indication. Coverage requires appropriate coding and clinical documentation showing medical necessity (nonhealing wound or failure of conventional care), wound surface area (97605 ≤50 cm2; 97606 >50 cm2), absence of FDA‑listed contraindications, and plan‑specific benefit eligibility.

"Powered negative pressure wound therapy (NPWT)/vacuum-assisted closure (VAC) (CPT 97605, 97606; HCPCS A6550, E2402) for nonhealing wounds is considered medically necessary."

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