Wound Care
L37228
This LCD covers active wound care procedures (debridement, biophysical agents including electrical stimulation, NPWT, MIST Therapy, and topical oxygen per referenced guidance) for wounds refractory to healing or with complicated healing when at least one qualifying wound condition is documented. MIST Therapy requires documented improvement after six treatments and is limited to no more than 18 services in a 6‑week period; NPWT and electrical stimulation coverage are governed by applicable DME LCDs and CMS NCDs. Routine cleansing is not considered debridement, E/M services same day as debridement require separately identifiable documentation, and skin substitutes, burns, skin cancer, and hyperbaric oxygen are outside the scope of this LCD.
"Coverage applies to wound care for wounds refractory to healing or with complicated healing cycles due to wound characteristics or metabolic/physiological factors."