Collagen is widely used and accepted for wound care and has been extensively researched. Collagen application provides the transdermal benefit of decreased inflammation and improved healing time thus decreasing infection susceptibility. Collagen is absorbed transdermally to improved cellular matrix for healing with macrophage and fibroblast effect to decrease inflammation, improve vascularization, etc., thus influencing the healing process with daily application per medical determination for utilization and improved patient outcomes. Transdermal transmission of collagen occurs to provide significant patient benefits of collagen that has been and is widely utilized both for incision and wound care. 

CMS has approved the use of collagen (primary dressing) and silicone foam (secondary) for 24-years. They have had the same A-codes attached to them and their reimbursement has actually gone up every year over the past 24-years. CMS makes it very clear that the primary collagen dressing and the secondary foam dressing are necessary, safe, effective, and have sufficient clinical evidence to support their efficacy.

Collagen Dressing

The collagen dressings are porous collagen membranes which are designed to be permeable and breathable, with fluid control similar to skin. They are flexible, pliable, elastic, and durable for ease of application.

Indications: Surgical wounds, dehisced surgical wounds and traumatic wounds, diabetic ulcers, pressure ulcers, and venous stasis ulcers.

Collagen Powder

The particles have a high surface area, allowing them to effectively penetrate and deliver the maximum amount of collagen into the wound surface.

Indications: Surgical wounds, dehisced surgical wounds, and traumatic wounds diabetic ulcers, pressure ulcers, and venous stasis ulcers.

Silicone Composite Dressing

The Silicone composite dressings are absorbent, have a non-traumatic border, and provide an ideal cover for wounds of many types. These dressings are indicated as a secondary dressing to cover primary dressings. They assist in protecting the wound and preventing bacterial contamination or maceration. These dressings are waterproof.

Indications: Post surgery sites, post operative wounds, diabetic ulcers, pressure ulcers, venous ulcers, and lacerations.

Island Composite Dressing

These dressings contain a non-adherent contact layer that covers the wound site. It consists of a soft absorbent pad that collects exudate and protects the wound from trauma. It also has a non-woven backing with an adhesive border that is gentle and holds the pad in place. The island composite dressing also has a waterproof backing to keep wounds dry and keep external contaminants out.

Indications: Post surgery sites, post operative wounds, diabetic ulcers, pressure ulcers, venous ulcers, and lacerations.

Following the CMS and Medicare LCD Guidelines

1. Encore and ANI always follow CMS guidelines. CMS and Medicare’s LCD guidelines are very clear regarding “How and When to Use These Products” and they state the following. “Medicare recognizes the surgical dressing materials described by the product types listed above to be effective. They are considered reasonable and necessary when used as described by this policy. Medicare limits reimbursement to items that have sufficient clinical evidence to demonstrate that use of the item is safe and effective.” Medicare goes on to state; “Any material other than the materials explicitly listed among the reimbursable dressing types discussed above (i.e., alginate, collagen, foam, gauze, hydrocolloid, hydrogel, etc.) is not considered reasonable and necessary until sufficient credible clinical evidence is available to justify inclusion of the material into this policy as a reimbursable surgical dressing component. *(Please see attachment #1 and the highlighted areas in red.)

2. Qualifying Wound / Indications for use / Medical Necessity per LCD Guidelines. Medicare tells us how and when to use products and surgical dressings. CMS defines a qualifying wound as; “A wound caused by, or treated by, a surgical procedure. *(Please see attachment #2 for specificity. There are black arrows next to the pertinent sections.) 

3. Medical necessity - Indications for use / CMS: “A collagen-based dressing or wound filler (collagen powder) is covered for “Full Thickness Wounds”. Thus, technically any patient receiving surgery is able to be prescribed HealPACK. *(Please see attachment #2 for additional specificity.)

4. By following CMS guidelines, the surgeon(s) typically understand that these are the highest quality PDAC products approved and reimbursed by CMS.