Billing and Coding: Spiracur SNaP Wound Care System

Effective for dates of service on and after January 1, 2013, Palmetto GBA will
reimburse Smart Negative Pressure (SNaP), a process that combines a suction
device with an advanced hydrocolloid wound dressing. SNaP delivers constant
and controlled levels of negative pressure to facilitate the healing of the
following types of open wounds:  
  
Stage III and IV pressure ulcer  
Neuropathic (diabetic) ulcer  
Chronic (present for at least 30 days) ulcer of mixed etiology  
Venous or arterial insufficiency ulcer  
Complications of a surgically created wound  
Traumatic wound  
  
Palmetto GBA expects providers to utilize all accepted wound care standards
prior to using SNaP.  
  
Accepted wound care standards include the following:  
  
Patient turning and positioning  
Appropriate surface modalities to prevent pressure wounds  
Appropriate management of moisture and incontinence  
Consistent application of compression garments and/or bandages  
Leg elevation and ambulation  
Appropriate topical wound treatments  
Appropriate necrotic tissue debridement  
Nutritional status evaluation with appropriate intervention  
  
The patient medical record maintained by the health care professional must
include the following patient-specific information:  
  
Physician order for treatment  
Documentation to substantiate standard protocols have been met  
Wound description including specific measurements and condition  
Patient-specific treatment plan  
  
**Coding/Billing Guidelines**  
  
 **CMS 1500 Form**  
An evaluation/management (E/M) service may be billed using the appropriate E/M
CPT code appended with the 25 modifier. The E/M service may only be submitted
when a separately identifiable service is performed besides the negative
pressure wound therapy. If the patient's condition warrants an additional E/M
service, the medical record must document the medical necessity for the E/M
service including the following:  
  
Wound description including specific measurements and condition  
Change in patient status  
A simple check of the wound does not justify an additional E/M service and
will be denied as not reasonable or necessary  
CPT code:

97607 (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 less than or equal to 50 square centimeters), or

97608 (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 centimeters)

*NOTE: CPT Codes 97607 and 97608 are not specific to the Spiracur SNaP Wound Care System. These CPT codes apply to any equivalent product. If a disposable negative pressure wound therapy (NPWT) product is used that meets the same specifications as the Spiracur SNaP Wound Care System, but is a different product, the product name should be entered in the Narrative field on the CMS 1500 Form.   
  
**UB-04 (CMS 1450 form) - Outpatient Treatment**  
To report a SNaP treatment in the outpatient setting, submit the following:  
  
CPT code:

97607 (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 less than or equal to 50 square centimeters), or

97608 (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 centimeters)

Enter 'Spiracur SNaP device' in the Remarks field (field locator 80) on the
UB-04 (CMS 1450 form)  
  
*NOTE: CPT Codes 97607 and 97608 are not specific to the Spiracur SNaP Wound Care System. These CPT codes apply to any equivalent product. If a disposable negative pressure wound therapy (NPWT) product is used that meets the same specifications as the Spiracur SNaP Wound Care System, but is a different product, the product name should be entered in the Remarks field (field locator 80) on the UB-04 (CMS 1450 form).