| Circulator Boot News
CMS Reimbursement Policy Update
"It's about time we improve access to care for CB therapy". This statement was recently made by the Medical Director for the CMS Contractor covering the Middle Atlantic region. End Diastolic Pneumatic Compression therapy (EDPC), aka Circulator Boot, has been slotted for favorable policy revision in February, 2010. The requested policy changes will include: 1. Reducing the waiting period for treatment from 24 weeks to 4 weeks, 2. Adding provider discretion for immediate treatment with urgent cases, 3. Eliminating the requirement for a Vascular Specialist evaluation prior to treatment, 4. Adding adjunctive therapy with revascularization as an approved regimen. Following the approval of this revised CMS policy (PA, NJ, DE, MD and DC) the CB team along with our reimbursement specialist, Corley Consulting, will be petitioning other regional contractors in an effort to secure coverage in areas currently served by existing CB clinicians. Success in securing these revisions requires support from our current user base. Please email Jack May to express support and learn more [email protected].
Circulator Boot Research...Seeking Clinical ParticipantsSeveral multi-site research programs are currently in various stages of study design. The prospective, randomized research programs target three specific areas where case data has already shown positive outcomes:
- EDPC for accelerating wound healing rates - The objective here is to provide evidence of the clinical and economic benefits of non-invasive/low cost EDPC therapy to improve healing rates and outcomes vs. conventional care for wounds present for greater than 4 weeks.
- EDPC used adjunctively to improve run-off following revascularization (endo and open) - A retrospective summary of positive data using this protocol is currently being formulated for publishing by Dr. Ramesh Adiraju at Lower Bucks Hospital in Bristol, PA.
- EDPC for patients that are poor candidates for HBO therapy - Patients with poor perfusion often present challenges to Wound Centers with an HBO centric protocol for wound healing. There is strong evidence that Circulator Boot therapy raises TCPO2 levels consistent with the minimum levels required for HBO therapy.
Resources for these studies have been budgeted. We welcome participation by current and prospective CB providers. Please contact Larry Hutchison to learn more [email protected].
Administrators: Reimbursement Best PracticesWe are completing a national review of CB reimbursement practices. Initial feedback highlights the need for more consistent and streamlined communications with 3rd party payers regarding Circulator Boot therapy. Our reimbursement specialist is finalizing a comprehensive Reimbursement Packet to be provided to all CB treatment centers. The Packet will include a template pre-authorization letter for private payers, a CMS letter to seek payment using the unlisted therapy code and a letter a patient can take to their benefits coordinator at their employer. The Packet will also contain instructions on the proper use of each form along with optimum patient data to be included with submission. For more information and best practices recommendations contact Stephanie Corley [email protected]. |
