We have some history with Pure Wick. We do not have anyone actively using this product in 2024, however we did encounter this issue in 2021, from what I can recall, it was
relatively new at that time. We had to contact Pure Wick to determine what our responsibility was - product is fairly expensive.
At that time
Pure Wick informed us Medicare would NOT cover the machine while client is under a home care episode. Medicare
would cover some of the cost when the client has been discharged from the home care episode but only 80% and they would need a preapproval from the PCP as to why it’s needed before Medicare would will approve coverage.
1.
The suction machine with wicks fell under HCPCS code K1006. Home health agency was not responsible for the cost, so the client would need to cover the cost of the product. Looks like this is still the case in 2024.
2.
In 2021 the wicks and the canister with tubing were listed under A4328 and A5102 which fell under our consolidated billing supplies. In 2024, it appears this has changed to A6590 and A9270 which is not our responsibility to cover.
I would agree the home health agency would not be responsible for covering he cost of this product.
From: medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org>
On Behalf Of Kirchoff, Jessica L
Sent: Monday, November 4, 2024 9:10 AM
To: medicarewkgp@list.mnhomecare.org
Subject: RE: [External Mail] RE: Pure Wick Flex Catheters
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From:
medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org> on behalf of Jill Arvidson <jarvidson@lifespark.com>
Sent: Monday, November 4, 2024 2:59:41 PM
To: medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org>
Subject: [External Mail] RE: Pure Wick Flex Catheters
Good Morning –
We are not covering this product for our HH clients. I polled the team and no one can think of even getting a request for this either.
We would not add it to our formulary.
I think you are on the right track. This is not an item we are responsible to cover. With that said, I hope it is not showing up on the new list of items to cover in 2025. Haven’t looked at that.
Have a good day.
Jill
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Jill Arvidson, MST, CCC-SLP Home Health Administrator Direct: 952-666-7705 Main: 952-345-3310
| Fax: 952-345-1101 Email:
jarvidson@lifespark.com
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www.lifespark.com
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From:
medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org>
On Behalf Of Kirchoff, Jessica L
Sent: Monday, November 4, 2024 4:57 AM
To: medicarewkgp@list.mnhomecare.org
Subject: Pure Wick Flex Catheters
[External Email: Use caution when clicking on links or opening attachments.]
Good Morning!
Question for the group –
Is anyone covering the cost of Pure Wick Flex Catheters for their home health patients? No insurance company is covering them and I found out that we have been covering the cost of them for a few patients.
Being they are not included in the consolidated billing list, it feels like we should be OK to have patient be billed for them.
I just wanted to see what others are doing with these, if you have patients using them.
Jessica Kirchoff OTR/L, MBA
Manager, Quality & Compliance – Home Health
Allina Health Home Health • Allina Health Commons
Office Phone: 612-262-7734• Mobile 612-810-4420 • Fax: 612-262-7643
Mail Route 10733 • 2925 Chicago Avenue • Minneapolis, MN 55407
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