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Medical Policy Revision: Negative-Pressure Wound Therapy

Effective March 19, 2018, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider claims for certain negative-pressure therapy services.

The guidelines of our medical policy, Negative-Pressure Wound Therapy, identify when services are considered medically necessary. We encourage you to review this policy in our Medical Policy Manual.


Based on the guidelines of our medical policy, Negative-Pressure Wound Therapy, claims for services provided on and after March 19, 2018 that include CPT® codes A7001 and/or A9272 will pend, regardless of the submitted diagnosis code(s) while information to help us determine if the service in question is medically necessary is requested and reviewed.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after March 19, 2018.

CPT® is a registered mark of the American Medical Association.

Published on: December 18, 2017, 12:05 p.m. ET
Last updated on: December 18, 2017, 12:06 p.m. ET