Navigation Links
Medicare coding for maggots and maggot therapy
Date:11/10/2008

Today, the BioTherapeutics, Education & Research (BTER) Foundation was notified that the American Medical Association (AMA), in collaboration with the Centers for Medicare and Medicaid Services (CMS) have just issued reimbursement coding guidelines for medicinal maggots and maggot therapy.

Appearing in the September, 2008 edition of CPT Assistant (Vol 18, Issue 9, page 11), the coding advisors wrote:

". . . . [CPT code] 97602 may be [used to report maggot therapy], as it is a type of nonexcisional debridement. To further clarify, the Centers for Medicare and Medicaid Services Transmittal 5, dated November 19, 2004, included maggot therapy as a type of debridement . . . . The supply of maggots should be reported in addition to the wound management code 97602 with CPT supply code 99070, Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies or materials provided)."

Earlier this year, the BTER Foundation formally requested that the AMA and CMS provide better guidance or specific codes to improve medical record documentation of maggot therapy and requests for reimbursement. In April, BTER Foundation Board Members Ronald Sherman of Irvine, California, and Pamela Mitchell from Akron, Ohio, were invited to appear at a public hearing at Medicare's Baltimore headquarters. They brought with them dozens of letters from maggot therapists and patients frustrated by their difficulties getting reimbursed by insurance companies and Medicare subcontractors for their maggot therapy expenses. Medicare officials were quite sympathetic to the requests for better coding and processing of insurance claims for maggot therapy, explaining that product coding and reimbursement needed to be coordinated with procedural coding and reimbursement.

In a letter received today by Dr. Sherman, Director of the BTER Foundation and Laboratory Director for Monarch Labs (producer of Medical Maggots brand of medicinal maggots), CMS officials announced their collaborative work with AMA, and the publication of their coding recommendations in CPT Assistant.

The letter and published coding advice were enthusiastically received by BTER Foundation members, as they will be by the entire wound care community. Not only do the coding recommendations reaffirm that maggot therapy is accepted by two of the most respected health care authorities in the nation, but these actions also demonstrate the continued commitment of AMA and CMS to patients and therapists who use medical grade maggots in wound care.

Maggot therapy is the use of specially prepared fly larvae for treating chronic wounds. Medical Maggots brand of medicinal maggots were granted marketing clearance by the FDA in 2004 for treating neuropathic (i.e., diabetic) foot ulcers, pressure ulcers ("bed sores"), venous stasis ulcers, and traumatic and post-surgical wounds failing other forms of conventional therapy. There are now over 1,000 therapists using maggot therapy in the U.S.

A treatment supply of medicinal maggots costs less than $100, but reportedly can save thousands or even tens of thousands of dollars in medical, surgical and hospital costs. "It's strange, but many insurance companies will pay tens of thousands of dollars for an amputation, probably because it is so common now-a-days, but will hesitate or object to paying $100 for a course of maggot therapy," said Dr. Sherman, "even though studies repeatedly demonstrate that medicinal maggots have saved 40-50% of limbs otherwise scheduled for amputation due to non-healing wounds." It's no wonder that more and more patients are demanding that their doctors try maggot therapy, even when patients are asked to pay for the treatments themselves.

Dr. Sherman added: "The timing of this recommendation, just before Veteran's Day, does not go unnoticed. The beneficial effects of maggots in wounds saved thousands of soldiers through the centuries, and it was a World War I surgeon, William Baer, who first developed the techniques of maggot therapy while at John Hopkins University." Dr. Sherman's own clinical studies were performed during the 1990's at the Veterans Affairs Medical Center in Long Beach, California, with funding from the Paralyzed Veterans of America.


'/>"/>

Contact: Ronald Sherman
RSherman@BTERFoundation.org
BioTherapeutics, Education & Research Foundation
Source:Eurekalert  

Related biology news :

1. Shape encoding may start in the retina
2. Decoding effects of toxins on embryo development
3. Scientists unravel the genetic coding of the pea
4. Decoding the dictionary: Study suggests lexicon evolved to fit in the brain
5. A new radiation therapy treatment developed for head and neck cancer patients
6. St. Jude finds factors that accelerate resistance to targeted therapy in lymphoblastic leukemia
7. UC health news: molecular pathway may predict chemotherapy effectiveness
8. MIT works toward safer gene therapy
9. Intravenous gene therapy protects normal tissue of mice during whole-body radiation
10. Gene, stem cell therapy only needs to be 50 percent effective to create a healthy heart
11. Fourth Annual International Conference on Cell Therapy for Cardiovascular Diseases
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Medicare coding for maggots and maggot therapy
(Date:2/2/2016)... YORK , Feb. 2, 2016 ... of that Rising Market Are you interested ... analysis forecasts revenues for checkpoint inhibitors. Visiongain,s report ... market, submarket, product and national level. Avoid ... discover what progress, opportunities and revenues those emerging ...
(Date:2/1/2016)... Feb. 1, 2016  Today, the first day of ... plans to develop a first of its kind workplace ... IBM Watson. In the first application of ... IBM ), and Welltok will create a new ... with cognitive analytics, delivered on Welltok,s health optimization platform. ...
(Date:1/25/2016)... , Jan. 25, 2016  Glencoe Software, the ... pharma and publication industries, will provide the data management ... Centre (NPSC). ... Phenotypic analysis measures ... whole organisms, allowing comparisons between states such as health ...
Breaking Biology News(10 mins):
(Date:2/10/2016)... ... February 10, 2016 , ... Curoverse ... Azure. On Azure, Arvados provides capabilities for managing and processing genomic and health ... Azure from major institutions collecting and analyzing genomic data,” said Adam Berrey chief ...
(Date:2/10/2016)... ... ... Cenna Bioscience Inc., an emerging biopharmaceutical company focused on the discovery and ... been selected to present at the Cavendish Global Health Impact Forum taking place February ... of the Forum is to help family offices and foundations develop and implement their ...
(Date:2/9/2016)... ... ... With a presidential election in November and the future of U.S. healthcare ... 500 top healthcare leaders for a night and day of debates and discussions about ... of the University of Pennsylvania’s Wharton School, will be held February 18 – 19, ...
(Date:2/9/2016)... ... 2016 , ... Date and time: March 1, 2016, 5:30 ... Biotechnology Center of Bucks County, 3805 Old Easton Road, Doylestown, PA 18902. , ... an open house for participants to learn about a new Master of Biomedical ...
Breaking Biology Technology: