CMS is seeking comparative evidence on negative pressure wound therapy (NPWT) devices as it evaluates existing Medicare codes for the products.

The review will be conducted under the Agency for Healthcare Research & Quality Technology Assessment Program, according to a Dec. 30 request for information.

In addition to the database review and literature searches AHRQ relies on for tech assessments, it is seeking information from interested stakeholders, particularly studies addressing the comparative benefits of NPWT, by Feb. 6.

The Department of Health and Human Services is required to review the Healthcare Common Procedure Coding System (HCPCS) code for NPWT devices under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

CMS generally considers HCPCS codes once a year, but occasionally conducts reviews outside that cycle when manufacturers seek unique codes for their products. The agency has been extremely selective when granting such requests, however (¹ Also see "Frustrated Manufacturers Will Go To HCPCS Meetings With Few Expectations" - Medtech Insight, 16 April, 2007., p. 9).

The decision to consider a unique code for NPWT could be a positive development for market leader Kinetic Concepts, which has long maintained its V.A.C. system should not be classified in the same code with less expensive negative pressure wound therapy devices (² Also see "Jury Deals Blow To Kinetic Concepts As Potential Medicare Cuts Loom" - Medtech Insight, 14 August, 2006., p. 16).

The firm says it is pleased with the decision to review NPWT and plans to submit data that will support its contention that V.A.C. should be grouped in a code with "comparable" products.

"Currently there is no evidence that other NPWT products provide comparable clinical or cost-effectiveness," KCI claims. Other companies marketing NPWT devices include Smith & Nephew ( EZCare , V1STA ), Medela ( Invia ) and Innovative Therapies Inc. ( Svedman ).

KCI last year decided against participating in Medicare's durable medical equipment bidding program, arguing that the program is not suited to complex technologies like V.A.C. (³ Also see "KCI Cites Flaws In Competitive Bidding Program, Declines To Participate" - Medtech Insight, 2 June, 2008., p. 9).

- Brooke McManus (b.mcmanus@elsevier.com)

CMS Reviewing HCPCS Coding For Negative Pressure Wound Therapy

More from Archive

More from Medtech Insight