Navigation Links
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 Meeting is to obtain industry and public reaction to CMS preliminary coding recommendations. According to the published meeting agenda, CMS officials plan to recommend that medicinal maggots not be given a reimbursement code because "No insurer (i.e., Medicare, Medicaid, Private Insurance Sector) identified a national program operating need to establish a HCPCS Level II code to identify Medical Maggots (http://www.cms.hhs.gov/MedHCPCSGenInfo/Downloads/SO-April22_2008.pdf).

Members of the BioTherapeutics, Education and Research (BTER) Foundation disagree with the CMS recommendation, and plan to demonstrate that beneficiaries, health care professionals and taxpayers do see a need for patients and their doctors to be able to use, code, and be reimbursed for using medicinal maggots. According to the charitys director, Dr. Ronald Sherman, BTER Foundation representatives will remind CMS officials that the same efficacy and safety studies that FDA evaluated before clearing Medical Maggots for marketing in the U.S. also demonstrated lower medical costs and high rates of limb salvage. In fact, when used on patients who failed all other medical and surgical treatments for their gangrenous wounds were offered only amputation or maggot therapy, 40-50% of patients who chose maggot therapy healed their wounds and saved their limbs. BTER Foundation members also will present study data that shows that many doctors will not prescribe maggot therapy when their insurance companies do not, or are perceived not to reimburse for the maggots. Not having a reimbursement code for medicinal maggots is like not allowing maggots on the formulary of any insurance company, he says. This is not what we would expect from Medicare, as the leading proponent of high-quality, equitable, cost-efficient medical care.

BTER Foundation Board member Pam Mitchell will also defend maggots at the hearing. She recently published her own experience in which she attributes medicinal maggots as saving her legs and her life (Maggots, Miracles Me, published 2007 by Xulon Press). Until a HCPCS code is established for medicinal maggots, she says, maggot therapy may remain more available for the wealthy who can pay one or two hundred dollars out of pocket rather than the majority of Americans, whether they have medical insurance or not. It seems like it is often easier to get your legs chopped off, and insurance will even pay for it, but not maggot therapy, even though maggot therapy could save your legs and a lot of money, too.


'/>"/>

Contact: Pam Mitchell
info@BTERFoundation.org
949-278-9756
BioTherapeutics, Education & Research Foundation
Source:Eurekalert  

Related medicine news :

1. Avalere Health Data Finds Four-Tier System Growing Among Medicare Part D Plans
2. Study details cost-effectiveness of rheumatoid arthritis treatments for Medicare recipients
3. RF Technologies Assists Healthcare Providers in Avoiding Preventable Injury Conditions to be Denied Reimbursement by Medicare
4. New Legislation Would Expedite Medicare Patient Access to Physical Therapy
5. New Medicare Equipment Bidding Program for Riverside, California Area is Rife with Errors, Says the American Association for Homecare
6. Medicare Bidding Program for Charlotte, N.C. is Plagued by Errors, Says American Association for Homecare
7. Medicare Bidding Program for Dallas, Texas is Rife with Errors, Says American Association for Homecare
8. ACP reports on how scheduled Medicare pay cuts will affect patients
9. Did Medicare Reimbursement Changes Affect Prostate Cancer Treatment?
10. Medicare Bidding Program in Kansas City is Plagued by Problems, Says American Association for Homecare
11. Errors Plague Medicare Competitive Bidding Program in Ohio, Says American Association for Homecare
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Medicare to consider public opinion about medical maggots
(Date:10/12/2017)... ... 2017 , ... Information about the technology: , Otomagnetics has ... prevention of a major side effect of chemotherapy in children. Cisplatin and carboplatin ... cisplatin, hearing loss is FDA listed on-label as a dose limiting toxicity. Hearing ...
(Date:10/12/2017)... ... 2017 , ... HMP , a leader in healthcare events and education, today ... Digital Award for ‘Best B-to-B Healthcare Website.’ Winners were announced during the Eddie & ... award competition recognizes editorial and design excellence across a range of sectors. This year’s ...
(Date:10/12/2017)... ... October 12, 2017 , ... On Saturday, October 21, the Health & ... by Moonlight to raise money for the American Heart Association Heart Walk. Teams of ... will work together to keep their treadmills moving for 5 hours. Treadmills will start ...
(Date:10/12/2017)... ... October 12, 2017 , ... Health ... interactive health literacy software tool, and the Cancer Patient Education Network (CPEN), an ... education, today announce a new strategic alliance. , As CPEN’s strategic partner, ...
(Date:10/12/2017)... ... October 12, 2017 , ... Vohra Chief Medical ... to physician colleagues, skilled nursing facility medical directors and other clinicians at various ... Wound Care." , "At many of these conferences we get to educate other ...
Breaking Medicine News(10 mins):
(Date:10/4/2017)... Mass. , Oct. 4, 2017 ... of single-use, self-contained, illuminating medical devices, today announced ... National Health Surveillance Agency (or Agência Nacional de ... The first single-use, cordless surgical retractor with integrated ... provides optimal access, illumination and exposure of a ...
(Date:10/2/2017)... , Oct. 2, 2017  AllianceRx Walgreens Prime, ... formed by Walgreens and pharmacy benefit manager Prime Therapeutics ... new brand, which included the unveiling of new signage ... , as well as at a few other company-owned ... new brand to patients, some of whom will begin ...
(Date:9/28/2017)... , Sept. 28, 2017 Hill-Rom Holdings, ... 2017 earnings conference call and webcast on Friday, November ... a.m. (EDT) and ending at approximately 8:30 a.m. (CDT) ... discussing the company,s 2017 financial performance and guidance for ... opportunities, initiatives to enhance operational performance, and long-range financial ...
Breaking Medicine Technology: