Wound Care

Medicare covers professional wound care for chronic or complicated wounds that are refractory to healing when comprehensive wound management is documented and measurable improvement is demonstrated; debridement is covered when necrotic or devitalized tissue or abnormal healing is present. NPWT is covered for specific complicated or non-healing wounds with weekly documented measurements, and MIST Therapy is covered for wounds intolerant of or not responsive to sharp debridement (typically provided 2–3 times/week with expected improvement by six treatments). Investigational methods, services lacking adjunctive measures, services for clean wounds without necrosis, and specified contraindications (eg, NPWT with exposed organs or untreated osteomyelitis) are not reasonable and necessary.

"Coverage is indicated for surgical wounds intentionally left open to heal by secondary intention."