Press & Announcements
PuraPly™ and PuraPly Antimicrobial (AM)™ Receive Permanent Q-Code, Expanding Medicare Coverage After January 1 to Include Treatment in Private Physician Office Setting
PuraPly Products Retain Pass-Through Reimbursement Status Throughout 2017
CANTON, Mass. ‐ December 14, 2016 Organogenesis Inc., a global leader in advanced wound care innovations and technologies, today announced that the Centers for Medicare and Medicaid Services (CMS) has assigned permanent Q-codes for its PuraPly™ and PuraPly Antimicrobial (AM)™ wound management products.
Starting January 1, 2017, both PuraPly and PuraPly Antimicrobial (AM) will be billed as Q-code Q4172 under the Healthcare Common Procedure Coding System (HCPCS). This change will expand coverage to include the private physician office setting, opening up a new site of care for Medicare patients with acute and chronic wounds.
Additionally, the new Q-code (Q4172), will replace the current C-code used to bill for the PuraPly line of products in the hospital outpatient and ambulatory surgery center settings.
"We’re pleased that this permanent code makes PuraPly more accessible to clinicians and patients in a wider array of clinical settings, especially PuraPly Antimicrobial, which is designed to prevent the reformation of biofilm in acute and chronic wounds," said Gary S. Gillheeney, Sr., President & CEO of Organogenesis. "In addition to the expansion into the private office setting, the products will remain on pass-through status until December 31, 2017 in the hospital outpatient and ambulatory surgical settings."
PuraPly™ and PuraPly Antimicrobial ™ are both FDA 510(k)-cleared Class II medical devices indicated for acute and chronic wound management across a wide variety of wound types, including partial- and full-thickness wounds, pressure ulcers, surgical wounds, trauma wounds, and venous and diabetic ulcers. PuraPly AM provides physicians with a new option for managing wounds contaminated with bioburden.
Although the code changed, the reimbursement for PuraPly and PuraPly Antimicrobial will remain the same for hospital outpatient departments and ambulatory surgery centers at average selling price (ASP) +6%. There will be separate reimbursement for product and procedure in the physician office. The switch from a C-code to a permanent Q-code will not change the pass-through status of Puraply and PuraPly Antimicrobial (AM). The products will remain on pass-through for reimbursement by CMS until December 31, 2017 and will be the only skin substitutes to have this status for the entirety of 2017.
PuraPly and PuraPly AM are manufactured at Organogenesis’ headquarters in Canton, Mass.
Massachusetts-based Organogenesis Inc. is a global leader in advanced wound care innovation and technologies, including bio-active wound healing and soft tissue regeneration. Organogenesis’ product portfolio includes FDA-approved Apligraf® and Dermagraft®, the best-in-class products for bio-active wound healing, and the recently launched, FDA-cleared PuraPly Antimicrobial™, which manages bioburden and supports healing for a wide variety of wound types.