This website uses cookies to store information on your computer. Some of these cookies are used for visitor analysis, others are essential to making our site function properly and improve the user experience. By using this site, you consent to the placement of these cookies. Click Accept to consent and dismiss this message or Deny to leave this website. Read our Privacy Statement for more.
Print Page | Sign In | Join
Medicare Fistula Coverage
Share |

Medicare Fistula Coverage

WOCN members have expressed a growing concern over the lack of access to supplies for patients who have nonsurgical and surgical related fistula.  These groups of patients are falling into a coverage gap that exists in post-acute, post home care with access to supplies. This issue has been noted in patients both pediatric and adult and more information can be found in a White Paper prepared by the Society.  In short, we see two distinct problems:

1. Despite available products, Medicare/Medicaid coverage is limited to only fistulas that are caused or treated by a surgical procedure.  Products for spontaneous fistula are not covered. 

2. There is only one covered product (Wound Pouch A6154) which is insufficient because fistulas very greatly in size location, output and complexity. 

In an effort to close this coverage gap WOCN has been working with other stakeholders to engage CMS in a conversation about how to change coverage policy so patients have access to these important supplies.  We are hopeful that this advocacy will result in a change in CMS coverage policy to ensure access.

Join Now Contact Us: info@wocn.org 888-224-WOCN(9626) Advertising

Copyright 2018 Wound, Ostomy and Continence Nurses Society™. All rights reserved.

The WOCN® Society is professionally managed by Association Headquarters, a charter accredited association management company.

The Wound, Ostomy and Continence Nurses Society is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

The Wound, Ostomy and Continence Nurses Society is approved by the California Board of Registered Nursing, Provider Number CEP 15115.

The WOCN® Society does not endorse or support products or services.

PLEASE BE ADVISED: The names and contact information for all individuals listed on this site is privileged, confidential information and intended for specific purposes. No one (individual or company) may use any contact information on the WOCN Society website to contact, to distribute information to, or solicit anyone for any reason other than the intended purpose for which the name and contact information is available. Click here to view our detailed Privacy Policy.