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 Setting

Effective October 1, 2016, Kerecis Omega3 Wound (Marigen) is reimbursed in the high cost group for applications of skin substitutes in the HOPD and 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 2017 is $1,427 in a Hospital Outpatient setting (site of service 22).

Physician’s Office Setting

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

Kerecis Omega3 Wound´s reimbursement is estimated at invoice cost. The invoice cost must be reported in box 19 of the claim form.

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, please send an inquiry to reimbursementus@kerecis.com or call our Reimbursement Hotline at 844-KERECIS (844-537-3247).