Negative Pressure Wound Therapy. Number 0. 33. 4Policy. Aetna considers negative pressure wound therapy NPWT pumps medically necessary, when either of the following criteria I or II is met Ulcers and Wounds in the Home Setting. The member has a chronic Stage III or IV pressure ulcer see Appendix below, neuropathic ulcer e. A complete wound therapy program described by criterion A and criterion B, C, or D below, as applicable depending on the type of wound, has been tried or considered and ruled out prior to application of NPWT. For all ulcers or wounds, the following components of a wound therapy program must include a minimum of all of the following general measures, which should either be addressed, applied, or considered and ruled out prior to application of NPWT Application of dressings to maintain a moist wound environment, and. Wounds UK Vol 9 No 4 2013 RESEARCH AND AUDIT Wound care in five English NHS Trusts Results of a survey T he population of the United Kingdom is. Infection can develop in any type of wound. In certain types of wounds and certain circumstances, developing an infection is more likely. There are a number. Understanding stoma complications on Wound Care Advisor By Rosalyn S. Jordan, RN, BSN, MSc, CWOCN, WCC, OMS and Judith LaDonna Burns, LPN, WCC, DFC About. Debridement of necrotic tissue if present, and. Documentation of evaluation, care, and wound measurements by a licensed medical professional, and. Evaluation of and provision for adequate nutritional status. For Stage III or IV pressure ulcers The member has been appropriately turned and positioned, and. The member has used a group 2 or 3 support surface for pressure ulcers on the posterior trunk or pelvis see CPB 0. Pressure Reducing Support Surfaces Note a group 2 or 3 support surface is not required if the ulcer is not on the trunk or pelvis, and. The members moisture and incontinence have been appropriately managed. For neuropathic e. The member has been on a comprehensive diabetic management program, and. Reduction in pressure on a foot ulcer has been accomplished with appropriate modalities. WoundHealingProcess.jpg' alt='Wound Dressing Types Pdf' title='Wound Dressing Types Pdf' />A surgical wound is a cut or incision that occurs during surgery. Learn about risks of infection, athome care, and more. For venous insufficiency ulcers Compression bandages andor garments have been consistently applied, and. Leg elevation and ambulation have been encouraged. Ulcers and Wounds Encountered in an Inpatient Setting. An ulcer or wound described in section I above is encountered in the inpatient setting and, after wound treatments described in I A through I D for the various types of ulcers above have been tried or considered and ruled out, it is necessary to initiate NPWT. The member has complications of a surgically created wound e. In either situation, II A or II B, NPWT will be considered medically necessary when treatment continuation is ordered beyond discharge to the home setting. Note NPWT pumps must be capable of accommodating more than 1 wound dressing set for multiple wounds on a member. Therefore, more than 1 NPWT pump billed per member for the same time period is considered not medically necessary. See specifications of equipment and supplies in the Appendix. Contraindications An NPWT pump and supplies is considered not medically necessary if one or more of the following contraindications are present The presence in the wound of necrotic tissue with eschar, if debridement is not attempted or. Osteomyelitis within the vicinity of the wound that is not concurrently being treated with intent to cure or. Cancer present in the wound or. The presence of an open fistula to an organ or body cavity within the vicinity of the wound. Continued Medical Necessity. For wounds and ulcers described in sections I and II above, once placed on an NPWT pump and supplies, in order to document continued medical necessity, a licensed medical professional must do the following On a regular basis, directly assess the wounds being treated with the NPWT pump, and supervise or directly perform the NPWT dressing changes, and. Example Example GoodGood Scheduled dressing change to Stage 3 pressure ulcer on LeftScheduled dressing change to Stage 3 pressure ulcer on Left. How to Attend to a Stab Wound. Painful, gory, and potentially deadly, a stab wound requires immediate treatment to alleviate the bleeding and pain and stabilize the. The VERSAJET II system enables a surgeon to precisely select, excise and evacuate nonviable tissue, bacteria and contaminants from wounds, burns and soft tissue injuries. Bleeding Apply direct pressure over wound. Place a sterile dressing or the cleanest cloth available over the wound. Protect yourself from coming in contact. The use of modern surgical dressings to prevent wound complications and surgical site infection SSI after minimally invasive total knee arthroplasty MISTKA is. Negativepressure wound therapy NPWT is a therapeutic technique using a vacuum dressing to promote healing in acute or chronic wounds and enhance healing of second. On at least a monthly basis, document changes in the ulcers dimensions and characteristics. Discontinuation Criteria. Project Pop Rapidshare there. For wounds and ulcers described in sections I and II above, an NPWT pump and supplies will be considered as not medically necessary with any of the following, whichever occurs earliest Any measurable degree of wound healing has failed to occur over the prior month. Wound healing is defined as improvement occurring in either surface area length times width or depth of the wound. There must be documentation of quantitative measurements of wound characteristics including wound length and width surface area, or depth, serially observed and documented, over a specified time interval. The recorded wound measurements must be consistently and regularly updated and must have demonstrated progressive wound healing from month to month or. Four months including the time NPWT was applied in an inpatient setting prior to discharge to the home have elapsed using an NPWT pump in the treatment of any wound. The medical necessity of NPWT beyond 4 months will be given individual consideration based upon required additional documentation or. In the judgment of the treating physician, adequate wound healing has occurred to the degree that NPWT may be discontinued, or. Once equipment or supplies are no longer being used for the member, whether or not by the physicians order or. When criteria under section on Continued Medical Necessity above, cease to be met. Supplies. Up to a maximum of 1. Adobe Serial Number'>Adobe Serial Number. Up to a maximum of 1. For high volume exudative wounds, a stationary pump with the largest capacity canister must be used. Excess utilization of canisters related to equipment failure as opposed to excessive volume drainage is not considered medically necessary. See specifications of equipment and supplies in the Appendix. Note Staging of pressure ulcers used in this policy is as follows Suspected Deep Tissue Injury. Purple or maroon localized are of discolored intact skin or blood filled blister due to damage of underlying soft tissue from pressure andor shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue. Easycap 2.0 Serial Number. Stage IIntact skin with non blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blancing its color may differ from the surrounding area. Stage IIPartial thickness loss of dermis presenting as a shallow open ulcer with red or pink wound bed, without slough. May also present as an intact or openruptured serum filled blister. Stage IIIFull thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining or tunneling. Stage IVFull thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling. Unstageable. Full thickness tissue loss in which the base of the ulcer is covered by slough yellow, tan, gray, green or brown andor eschar tan, brown, or black in the wound bed. Aetna considers NPWT experimental and investigational for the following because its effectiveness for these indications has not been established not an all inclusive list For use following cardiac surgery e. For use following knee arthroplasty not meeting criteria above. For use following surgical excision of pilonidal sinus disease and for recurrent pilonidal disease. For use in kidney transplantion in recipients not meeting criteria above. Prevention of complications in surgical wounds of the abdomen based upon presence of diabetes or obesity as risk factors. Prophylactic use after cesarean delivery. Prophylactic use after ventral hernia repairs. Treatment of deep sternal wound infection, partial thickness burns, tibial fractures. Aetna considers the use of chemotherapeutic agents e.