wound vac supplies and Medicare

[chenoaspirit, ASN, RN]

Now, I dont understand medicare, or part A verses part B, etc. Anyhoo, I have a wound vac patient (homehealth) who has a MASSIVE dressing. I needed more drape because it just takes so much after bordering the wound then covering the foam, etc. I called KCI and ordered one package of drape so it would be there this week when I go and do the changes. I later started wondering, should I have done that? I mean, will medicare pay for it? He has part A and part B. The drape is absolutely needed. This wound is HUGE! I guess I need to talk to my boss tomorrow, but Im worrying. Im new to homehealth and Im starting to hate the vast amount of knowledge Im supposed to have, lol.

[NRSKarenRN, BSN, RN]

medicare part a covers hospital, home health and snf care with homecare covered 100% if not in medicare advantage program and homebound

medicare part b pays physicians and dme @ 80% with 20% copay. home care can be covered under part b when patient without part a coverage.

wound vac covered under part b with doctors order, appropriate dx only 80%....

if patient has other secondary insurance, 20% would be payed by that policy.

see: 2009 medicare

medicare part a (hospital insurance)

helps cover inpatient care in hospitals

■■helps cover

■■skilled nursing facility, hospice, and home health care

see pages 16–20.

medicare part b (medical insurance)

helps cover doctors’ services and outpatient care

■■helps cover some preventive services to help maintain your health

■■and to keep certain illnesses from getting worse

see pages 21–37.

medicare part c (medicare advantage plans) (like an hmo or ppo)

a health coverage choice run by private companies approved by medicare

■■includes part a, part b, and usually other coverage including prescription drugs

see the next page.

medicare part d (medicare prescription drug coverage)

helps cover the cost of prescription drugs

■■may help lower your prescription drug costs and help protect against

■■higher costs in the future

see pages 63–71.

[annaedRN, RN]

Karen as always answers the questions so well! You were fine in ordering the needed supplies. You will occasionally run into problems with KCI saying that the request is an excessive supply for the month - they will send those "excessive" supplies once approved by the doc. Just document the wound size, drainage, etc accurately to help prove your need ( and will be needed for monthly progress form anyway) On a side note, since we cannot send back the boxes of opened supplies once a patient is d/c'd from the VAC, we take the individual sealed dressings and canisters from those opened boxes and keep them with our supplies in our freebie section...helps to have the extras to access in a pinch...for those with the large wounds or ones that leak and need rechanged/patched frequently.

[chenoaspirit, ASN, RN]

monthly progress forms? uh oh. ok, what is that. lol. Is there a form I have to fill out for KCI? I hate the paperwork portion of HH.

[txspadequeenRN, BSN, RN]

i was goggling this subject and ran across this thread....my mother is on a wound vac now and needs to go home with one tomorrow......hello...the social worker just came in and told me the 20% we have to pay is $500 month and that it cost like 5k total a month for the wound vac (kci)....is this normal charges if so i am in the wrong business...

[mamamerlee, LPN]

KCI is extremely knowledgeable about what is covered, and their personnel will walk you thru all the paperwork. As for the excess supplies, any unopened boxes of items must be sent back to KCI for credit. And once ANYTHING has been in a pt's home, it CANNOT be brought back to your agency for any reason - despite being sealed, the outside of the product is 'contaminated' with anything that may be in the pt's home. Dust, pet dander, simple handling. Those old 'freebie' closets are a thing of the past. If your agency is inspected and that closet is opened, you will be cited.