Kerecis Omega3 Wound

U.S. REIMBURSEMENT

Kerecis Omega3 Wound has coverage in all 50 states through Medicare and wide coverage through private insurers. Kerecis Omega3 Wound is available in Veterans Administration hospitals and is on the Federal Supply Schedule in all Veterans Integrated Service Networks (VISNs).

Hospital Outpatient Department

Effective October 1, 2016, Kerecis Omega3 Wound (Marigen) is reimbursed in the high cost group for applications of skin substitutes in the HOPD setting using CPT codes 15271-15278.

Medicare payment for Q4158 – Kerecis Omega3 Wound (Marigen) is included in the payment for the application. The Medicare National Payment rate for high cost group in 2017 is $1,568.43 in a Hospital Outpatient setting (site of service 22).

Ambulatory Surgical Center

Effective October 1, 2016, Kerecis™ Omega3 Wound (Marigen) is reimbursed in the high cost group for applications of skin substitutes in the ASC setting using CPT codes 15271-15278.

Medicare payment for Q4158 – Kerecis™ Omega3 Wound (Marigen) is included in the payment for the application. The Medicare National Payment rate for high cost group in 2018 is $817.15 in a Freestanding Ambulatory Surgical Center (site of service 24).

Physician’s Office Setting

Kerecis has a separate reimbursement for Q4158 if applied in a physician’s office (site of service 11).

Contact the Reimbursement Hotline at 844-KERECIS (844-537-3247) for Benefit Investigation and fee schedule information.

Reimbursement Hotline and Benefit Verification

Once you decide to use Kerecis Omega3 Wound, our Reimbursement Hotline team will work closely with you throughout your benefit verification and prior authorization and update you on the policy status of Kerecis in your area.

If you have any questions about reimbursement for Kerecis Omega3 Wound, contact us:

Email: reimbursementUS@kerecis.com
Reimbursement Hotline: 844-KERECIS (844-537-3247)
Fax: 844-529-3247

>> Click here for the Kerecis Benefits Investigation Request Form