Coverage guidelines

Prior to application, physicians or other qualified healthcare professionals (QHPs) should confirm or clarify coding and coverage with their respective local Medicare Administrative Contractor, as each contractor may have differing formal or informal coding or coverage policies. Prior to application, physicians or QHPs should also conduct insurance benefit verification with private payers or Medicaid, where applicable.

Physicians or QHPs are responsible for accurate documentation of patient conditions and appropriate reporting of procedures and products.

Indications and Contraindications

The PICO Single Use Negative Pressure Wound Therapy System is indicated for the management of wounds including:

  • Chronic
  • Acute
  • Traumatic
  • Subacute and dehisced wounds
  • Partial-thickness burns
  • Ulcers (such as diabetic or pressure)
  • Flaps and grafts
  • Closed surgical incisions

PICO Single Use Negative Pressure Wound Therapy System is contraindicated in the presence of:

  • Patients with malignancy in the wound bed or margins of the wound (except in palliative care to enhance quality of life)
  • Previously confirmed and untreated osteomyelitis
  • Non-enteric and unexplored fistulas
  • Necrotic tissue with eschar present
  • Exposed arteries, veins, nerves of organs
  • Anastomotic sites
  • Emergency airway aspiration
  • Pleural, mediastinal or chest tube drainage
  • Surgical suction

Please review the Local Coverage Determination (LCD) specific to the Medicare Administrative Contractor that processes your claims, the medical policies of the private payers in your geographic area who insure your patients, and your state's Medicaid policies to confirm the indications that are covered