If the treatment regimen exceeds the quantity limitations allowed by Medicare, then a Letter of Medical Necessity must be signed by the physician and kept in the patient’s records.

Surgical dressings are covered when either of the following criteria are met:

They are medically necessary for the treatment of a wound caused by, or treated by, a surgical procedure; or

They are medically necessary when debridement of a wound is medically necessary.

Surgical dressings include both primary and secondary dressings.

Primary=therapeutic or protective coverings applied directly to wounds or lesions either on the skin or caused by an opening to the skin, and

Secondary=materials that serve a therapeutic or protective function and that are needed to secure a primary dressing.

The surgical procedure or debridement must be performed by a physician or other healthcare professional, and can be of any type:

surgical (e.g., sharp instrument or laser),

mechanical (e.g., irrigation or wet-to-dry dressings),

chemical (e.g., topical application of enzymes),

or autolytic (e.g., application of occlusive dressings to an open wound).

Dressings used for mechanical debridement, to cover chemical debriding agents, or to cover wounds to allow for autolytic debridement are covered--although the agents themselves are not.

Surgical dressings (whether primary or secondary) are covered for as long as they are medically necessary.