OASIS Alert

Published on Wed May 26, 2004 PDF

And it begins next month.

Agencies with well-equipped therapists may find it easier to say "yes" to M0825.

The Centers for Medicare & Medicaid Services has reconsidered its previous coverage decision and will pay for electromagnetic therapy for wound healing beginning July 1. 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 a revision to the National Coverage Determination Manual.

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

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

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

When PTs provide this service in the home it does qualify for M0825, CMS confirmed in the April 28 Open Door forum for home care.

If a physician provides the therapy or it is incident to a physician's services, the visits won't count toward M0825. And it is more likely patients will go to a wound care center to receive treatments, since many HHAs won't invest in e-magnetic therapy equipment, predicts wound care expert Liza Ovington with Pittsburgh-based Ovington & Associates.

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