Medicare Compliance & Reimbursement

Good news for therapists, home health agencies and patients.

Home health patients with chronic wounds may have a new source of treatment hope: electromagnetic therapy.

The Centers for Medicare & Medicaid Services originally decided not to cover electromagnetic therapy for wound healing. But the agency now has reconsidered and will cover the service starting July 1, CMS says in a March 19 national coverage determination.

Medicare will cover e-magnetic therapy when a physician or physical therapist uses it to treat chronic Stage III or Stage IV pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers, CMS says in its revision to the National Coverage Determinations Manual.

E-magnetic and electrical stimulation therapy are covered only once "appropriate standard wound therapy has been tried for at least 30 days" with no measurable signs of improved healing, CMS says. And the treating physician must evaluate the wound(s) "at least monthly" while e-magnetic therapy is used, the determination adds.

E-magnetic therapy, which uses a pulsed magnetic field to induce current across the wound, has similar results as e-stimulation therapy, CMS has decided.

It appears e-magnetic therapy "would qualify for the therapy threshold for a yes response on M0825, since a PT can administer this modality," notes wound care nurse Patti Johnston, president of Positive Outcomes Inc. in The Woodlands, TX.

But it is unlikely many home care companies will invest in electromagnetic therapy equipment, so patients most likely would go to a wound care center to receive treatment, expects wound care expert Liza Ovington with Pittsburgh-based Ovington & Associates.

If the therapy is furnished by a physician or incident to a physician's services, the visits wouldn't count toward M0825.

Home health agencies will have a number of other billing and documentation questions about the service not addressed by CMS in the determination, Johnston adds.

Nonetheless, the announcement is definitely good news for home health agencies and therapists.

Editor's Note: The determination is at www.cms.hhs.gov/manuals/pm_trans/R7NCD.pdf.