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Medicare to consider public opinion about medical maggots
Date:4/21/2008

At its upcoming Public Meeting on April 22, 2008, the Centers for Medicare and Medicaid Services (CMS) will solicit public input for the establishment of a Healthcare Common Procedure Coding System (HCPCS) for medicinal maggots.

Level II of the HCPCS is a standardized coding system that is used to identify products, supplies, and services not included in the Current Procedural Terminology (CPT) coding system assigned by the American Medical Association to describe most procedures. Together, CPT codes and HCPCS codes are the mechanism by which most procedures and medical products in this country are listed on insurance claim forms and subsequently reimbursed.

Medical grade maggots have been used in this country for almost 80 years, but it was not until 2003 that they began to be regulated by the Food and Drug Administration (FDA). In January, 2004, Medical Maggots became the first living organism to receive marketing clearance by the FDA as a prescription medical device. Based on efficacy and safety studies, Medical Maggots can be marketed for the treatment of non-healing necrotic wounds, such as pressure ulcers, most diabetic foot ulcers, chronic leg ulcers and traumatic wounds.

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. Yet, CMS still has not provided the health care industry with a reimbursement code for this critical wound care product.

The AMA considered a CPT code for maggot therapy 3 years ago and again last month. Their decision remains unchanged: clinicians should be reimbursed for their time doing maggot therapy by using standard wound care procedure reimbursement (CPT) codes that already exist. Reimbursement for the additional cost of the maggots, they said, should be obtained by using a designated HCPCS code, to be assigned by CMS.

The purpose of the upcoming Public Me
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Contact: Pam Mitchell
info@BTERFoundation.org
949-278-9756
BioTherapeutics, Education & Research Foundation
Source:Eurekalert  

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