Negative Pressure Wound Therapy Pumps
L33821
Negative Pressure Wound Therapy pumps (E2402) and supplies (A6550, A7000) are covered when used for chronic Stage 3–4 pressure ulcers, neuropathic (e.g., diabetic) ulcers, venous/arterial insufficiency ulcers, or chronic mixed-etiology ulcers after a complete wound therapy program has been tried or considered and ruled out. Coverage requires documented wound evaluation and monthly measurements, specific pre-NPWT measures (e.g., debridement, moist dressings, nutrition, offloading/compression/support surfaces), PDAC designation for the pump, and adherence to supply limits (max 15 dressing kits/wound/month and max 10 canisters/month unless >90 ml/day), with a maximum NPWT duration of 4 months per wound. Claims lacking required written orders (SWO/WOPD), proof of delivery, proper documentation, or PDAC designation, or that meet exclusion conditions (untreated osteomyelitis, cancer in wound, open fistula, necrotic eschar not debrided) will be denied.
"NPWT pump (E2402) and supplies (A6550, A7000) are covered in the home setting for beneficiaries with a chronic (>=30 days) Stage 3 or 4 pressure ulcer, neuropathic (e."