PURAPLY®AM PROVIDER REIMBURSEMENT SUPPORT
Organogenesis provides information on coding, coverage, and reimbursement in addition to other tools for PuraPly AM. Additional information is also available from the Centers for Medicare and Medicaid Services (CMS).
For answers to any questions regarding reimbursement, healthcare providers can reach out to the Organogenesis Reimbursement Hotline at 1-888-432-5232 (select option 3) or email us at firstname.lastname@example.org.
Q CODE UPDATE
As a skin substitute with advanced technology, PuraPly AM is reimbursed in the high bundle by CMS. PuraPly AM and PuraPly are eligible for reimbursement for all sites of care. Effective January 1, 2019, each product now has its own Q code:
Q4196: PuraPly AM
PASS-THROUGH STATUS EXTENDED THROUGH SEPTEMBER 30, 2020
CMS extended pass-through status to a select group of medical products identified as "truly innovative" to foster innovation and broaden access for Medicare beneficiaries.
Product reimbursement and facility fee
Pass-through allows for potential additional product reimbursement on top of a facility fee for a limited amount of time.
Medicare patients in 2 sites of care
Applies to Medicare patients treated in hospital outpatient sites and ambulatory surgical centers.
Positive reimbursement across all sizes
As the only skin substitute with pass-through status, PuraPly AM offers separate reimbursement across all sizes—to treat all wounds.
Prices will continue to be lower per square centimeter than other competitive skin substitutes on the market today.
BENEFIT VERIFICATION AND PRIOR AUTHORIZATION PROGRAM
Once you have decided to use PuraPly or PuraPly AM, our team of Reimbursement Support Center Specialists will work closely with you through our benefit verification and prior authorization program. If needed, they are also available to perform a claims analysis and assist with appeals.
READY TO TAKE CONTROL OF
THE HEALING ENVIRONMENT?
Talk to an Organogenesis Tissue Regeneration Specialist about using PuraPly AM, the advanced antimicrobial barrier with native, cross-linked ECM + broad-spectrum PHMB.Contact us