Juxta-Lite™: 2012 Coded, Covered, & Published Fee Schedule*
San Diego, Calif., December 15, 2011 – As of September 1, 2010 CircAid® Medical’s Juxta-Lite™ product was code verified by the Medicare PDAC under the HCPCS code A6545. This code is a part of the Surgical Dressing Medicare Local Coverage Determination (LCD) and related policy article. It is covered by Medicare Part B (DMEPOS) when used for the treatment of an open venous ulcer. Effective January 1, 2012, the published fee schedule for HCPCS code A6545 when billed with the AW modifier is $91.50 for all states. The fee schedule can be found on the PDAC website.
Summary of Billing Instructions from the Article for Surgical Dressings – Policy Article – January 2010The only products that may be billed with code A6545 (inelastic compression wrap) are those which have received a written Coding Verification Review from the Pricing, Data Analysis, and Coding (PDAC) contractor and that are posted in the Product Classification List on the PDAC web site.
When the compression wrap code A6545 is used for an open venous stasis ulcer, the code must be billed with the AW modifier (but not an A1-A9 modifier). The RT (right) and/or LT (left) modifiers must be used with code A6545. When the same code for bilateral items (left and right) is billed on the same date of service, bill both items on the same claim line using RTLT modifiers and 2 units of service. Claims billed without modifiers RT and/or LT will be rejected as incorrect coding. Coverage of compression wrap (A6545) is limited to one compression wrap per 6 months per leg.
Suppliers should refer to the Surgical Dressings LCD and related Policy Article for additional guidance on the coverage, coding and documentation requirements.In the event that a claim is denied or if you have any questions related to reimbursement, you may contact CircAid.
*Please note that this communication is not intended to provide Medicare billing advice. Medicare billing questions should be directed to your Medicare Administrative Contractor or CMS.
About CircAid® Medical Products, Inc.
CircAid® specializes in creating alternative compression garments for the treatment of Lymphedema, Venous Disease and other Edema related disorders. CircAid® Medical's products series, Juxta-Fit™ and Juxta-Lite™, are recognized in the industry as the perfect alternative to traditional compression therapy. By maintaing constant, ongoing dialogue with patients, physicians and other medical professionals, CircAid® continues to devote time, resources and research to product innovation to ensure that patients have the most comfort while enabling them to maintain an independent lifestyle.
For more information contact:
CircAid® Medical Products, Inc.
(800) CIRCAID (247-2243)
+1 (858) 576-3550
info@circaid.com
www.circaid.com