Transcription of Negative Pressure Wound Therapy - UHCprovider.com
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Negative Pressure Wound Therapy Page 1 of 14 UnitedHealthcare Commercial Medical Policy Effective 05/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services, Inc. UnitedHealthcare Commercial Medica l Policy Negative Pressure Wound Therapy Policy Number: 2022T0594F Effective Date: May 1, 2022 Instructions for Use Table of Contents Page Coverage Rationale .. 1 Documentation Requirements .. 2 Definitions .. 3 Applicable Codes .. 3 Description of Services .. 4 Clinical 4 Food and Drug 11 References .. 11 Policy History/Revision Information .. 14 Instructions for 14 Coverage Rationale Notes: The proven and medically necessary coverage statements in this policy apply to the use of Negative Pressure Wound Therapy (NPWT) in the outpatient setting.
Negative pressure wound therapy, (e.g., vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area greater than 50 square cen timeters ...
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