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Reimbursement

As a value-added service, Derma Sciences offers the Derma Sciences Reimbursement Hotline 1-800-474-9511

Derma Sciences Reimbursement Hotline is dedicated to assist customers and provide information on coding, coverage and reimbursement.

Contact the Derma Sciences Reimbursement Hotline: Monday to Friday 9:00 a.m. - 6:00 p.m. ET
Tel: 1-800-474-9511, Fax: 1-844-868-0930, email or Download PDF Form

The Derma Sciences Reimbursement Hotline is staffed with HIPAA compliant reimbursement professionals from Argenta ReSource to support you in the following ways: 

Answer coding, coverage and reimbursement questions when reporting the use of AMNIOEXCEL®, AMNIOMATRIX®, TCC-EZ®, MedE-Kast® or any other Derma Sciences advanced wound care product

  • Conduct pre-authorizations for procedures utilizing AMNIOEXCEL® and AMNIOMATRIX® products
  • Sample letters of medical necessity and claims appeals
  • Post claims appeals


To submit a reimbursement question click here

All coding selection is at the discretion of the provider and based on documentation. It is advised to contact your local payor directly for coding guidance and requirements when reporting the use of AMNIOEXCEL®, AMNIOMATRIX®, TCC-EZ®, MedE-Kast® or any other Derma Sciences advanced wound care product.

All services provided are complimentary

Disclaimer: The information has been prepared for providers choosing a Derma Sciences product and is intended for informational purposes only. It does not represent a guarantee, promise or statement by Derma Sciences Inc. concerning levels of reimbursement, payment or charges. It is not intended to increase or maximize reimbursement. The decision as to regarding the procedure code selection, completion of a claim form and/or amount to bill, is exclusively the responsibility of the provider procedure and product codes provided are for information purposes only and should be verified according to the requirements of each payor.

Medicare Part B coding and coverage reinstated for MEDIHONEY® Dressings

Medicare Part B coverage was reinstated with the reassignment of HCPCS code A4649 for MEDIHONEY® dressings. This change is effective retroactive to January 30, 2015. Confirmation of this may be found at www.dmepdac.com. Orders for MEDIHONEY® dressings that came in from January 30 to today, may be submitted to Medicare Part B using A4649.


Guidance for the Clinician: Based on feedback from the 4 DME MACs and DME suppliers, the following guidance was provided concerning required documentation. As with any other dressings, for each order for MEDIHONEY® product, the following information must be submitted by you, the clinician, to the DME supplier*:

  • evaluation of the patient's wound[s]including
    • type of each wound (e.g., surgical wound, pressure ulcer, burn, etc),
    • its location,
    • the amount of drainage and
    • any other relevant information
    • its size (length x width in cm.) and depth,
  • number of surgical/debrided wounds being treated with a dressing,
  • reason for dressing use (e.g., surgical wound, debrided wound, etc.), and whether the dressing is being used as a primary or secondary dressing
  • specify which MEDIHONEY® dressing and the reason. The low pH and high osmolarity resulting from using MEDIHONEY® dressings are unique and needed to aid autolytic debridement and healing.
  • the type of dressing (e.g., hydrocolloid wound cover, hydrogel wound filler, etc.),
  • size of the dressing
  • number/amount to be used at one time (if more than one)
  • frequency of dressing change, and
  • expected duration of need

*Contact your DME Supplier directly to determine their specific documentation and ordering requirements and potential patient responsibility forms in the event their payor does not reimburse the product. Please work with your DME provider to address their specific requirements.


DME Supplier: We queried the 4 DME MACs and the guidance they provided is the following:

  • Be sure to complete block #19 with the following information:
    • Manufacturer name
    • Product ID# and brand name
    • Size of product
    • Narrative justifying the medical necessity for the MEDIHONEY® dressing
    • MSRP*
  • Be sure to assign the necessary modifiers as outlined in the LCD

As with any other dressings, for each order for MEDIHONEY® product, the following must be kept on file:

  1. the type of dressing (e.g., hydrocolloid wound cover, hydrogel wound filler, etc.),
  2. the size of the dressing (if appropriate),
  3. the number/amount to be used at one time (if more than one),
  4. the frequency of dressing change, and
  5. the expected duration of need

Documentation requirements are include for A4649, Surgical Supply, miscellaneous, in each of the DME MAC LCDs for surgical dressings which can be found at www.cms.gov/medicare-coverage-database.

  • Region A:NHIC, LCD#L11471
  • Region B: NGS, LCD#L27222
  • Region C: CGS, LCD#L11449
  • Region D: Noridian, LCD#L33831


All other requirements for documentation for frequency of evaluation by a clinician of the patient’s wound[s], and utilization frequency for each dressing type are outlined in the LCD.

For your convenience, below is a chart of MEDIHONEY® dressings and associated HCPCS.

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Product & Size Product Code HCPCS
Adhesive HCS Dressing, 2.8" x 2.8" 31722 A4649
Adhesive HCS Dressing, 4.5" x 4.5" 31744 A4649
Non-Adhesive HCS Dressing, 2.4" x 2.4" 31622 A4649
Non-Adhesive HCS Dressing, 4.33" x 4.33" 31644 A4649
Fenestrated Non-Adhesive HCS Dressing, 1.8" x 1.8" 31618 A4649
Calcium Alginate, ¾" x 12" 31012 A4649
Calcium Alginate, 2" X 2" 31022 A4649
Calcium Alginate, 4" x 5" 31045 A4649
Paste, 0.5 oz tube 31505 A4649
Paste, 1.5 oz tube 31515 A4649
Paste, 3.5 oz tube 31535 A4649
Gel, 0.5 oz tube 31805 A4649
Gel, 1.5 oz tube 31815 A4649
Adhesive Honeycolloid™ dressing, 2" x 2" ( 3 ½" x 3 ½"w adhesive border) 31422 A4649
Adhesive Honeycolloid™ dressing, 4 ½" x 4 ½" (6" x 6" w adhesive border) 31445 A4649
Non-Adhesive Honeycolloid™ dressing, 2" x 2" 31222 A4649
Non-Adhesive Honeycolloid™ dressing, 4" x 5" 31245 A4649

*MSRP information may be obtained from your DermaSciences sales representative.

If you have any questions, concerning product ordering, please contact our Customer Service Center 1-800-825-4325 for assistance. For questions concerning, coding and coverage for MEDIHONEY® dressings, please contact the DermaSciences Reimbursement Hotline at 1-800-474-9511 or at .

The Derma Sciences Reimbursement Hotline has secured individual coverage approvals of AMNIOEXCEL® for use on chronic wounds from the following health plans:

Medicare Advantage Plans

  • Humana
  • BCBS of OH
  • BCBS of MI
  • BCBS of NC
  • Essence Medicare Advantage
  • United Healthcare Medicare Advantage
  • Regence
  • Select Health SC
  • Care Improvement Plus
Commercial Plans

  • Amerigroup
  • BCBS FEP
  • BCBS FL
  • Blue Choice (SC)
  • Care Improvement Plus
  • First Health Network
  • Medcost (SC)
  • Health Cost Solutions
  • Health Plan of San Joaquin
  • Netcare
  • First Carolina Care
  • Tufts Associated Health Plan
  • United Healthcare
  • Non VA Care
Managed Medicaid

  • SC Medicaid


Additionally, use of AMNIOEXCEL® may be considered reasonable & necessary for Medicare Part B patients in the follow MAC jurisdictions: Noridian, Novitas, Wisconsin Physician Services, Palmetto GBA, and First Coast Service Options. Please consult the Local Coverage Determination for specific coverage and documentation requirements at: https://www.cms.gov/medicare-coverage-database

Check the Reimbursement Coding Page for the 2016 Coding Guide for Amniotic Products.

If you have patients who may benefit from use of AMNIOEXCEL®, and would like assistance with verifying benefits or the preauthorization process, be sure to reach out to the Derma Sciences Reimbursement Hotline at 1-800-474-9511 or .

Contact the Derma Sciences Reimbursement Hotline: Monday to Friday 9:00 a.m. - 6:00 p.m. ET
Tel: 1-800-474-9511 Fax: 1-844-868-0930 OR email

The Derma Sciences Reimbursement Hotline is staffed with HIPAA compliant reimbursement professionals from Argenta ReSource to support you in the following ways:

  • Answer coding, coverage and reimbursement questions
  • Sample letters of medical necessity and appeal
  • Assistance with Benefits Verification and payor processes
  • Assistance with individual consideration requests for medical necessity
  • Post claims appeals

Many payors may not be familiar with AMNIOEXCEL® and AMNIOMATRIX® with regards to the use of amniotic tissue on chronic wounds and frequency of the application. This may lead to challenges with claims adjudication and payment.

If you have reimbursement questions concerning AMNIOEXCEL® and AMNIOMATRIX® please contact the Derma Sciences Reimbursement Hotline at 1-800-474-9511 or submit your questions to

Amniotic Tissue Product Coding:
Download Amniotic Tissue Product Coding PDF
Download Sample ICD-10 diagnosis codes PDF

Reimbursement Inquiry:

Amniotic Tissue Product Forms:
Download PDF Sample AMNIOEXCEL® appeal letter
Download PDF Sample AMNIOMATRIX® appeal letter
Download PDF Sample AMNIOEXCEL® preauth letter
Download PDF Sample AMNIOMATRIX® preauth letter
Download PDF Sample Amniotic Tissue Authorization PHI form
Download PDF Sample AMNIOEXCEL® Benefit Investigation form
Download Business Associate Agreement for Derma Sciences Hotline PDF Form
Download PDF DermaSciences Hotline Intake Form
Download PDF AMNIOEXCEL AMNIOMATRIX Request Support Form

The 2015 Medicare National Average Hospital Outpatient Payment associated with the application of TCC-EZ® is $223.20 (CPT® Procedure Code 29445), representing an increase of 61%, compared with the 2014 Medicare National Average Payment of $138.31. The increase in payment recognizes the appropriate value of applying the TCC-EZ® and the improved healing rates that result during the management of diabetic foot ulcers. The new payment rates should encourage utilization of this technology by clinicians. Our TCC-EZ® is the market leading total contact casting system and its ease of use has been the primary driver for increased adoption of total contact casting.

Download 2016 TCC Coding Reimbursement Guide


Contact the Derma Sciences Reimbursement Hotline: Monday to Friday 9:00 a.m. - 6:00 p.m. ET
Tel: 1-800-474-9511 Fax: 1-844-868-0930 OR email

The Derma Sciences Reimbursement Hotline is staffed with HIPAA compliant reimbursement professionals from Argenta ReSource to support you in the following ways:

    Answer coding, coverage and reimbursement questions when reporting the use of TCC-EZ®, MedE-Kast® or MedE-Kast® Ultra.

  • Sample letters of medical necessity and claims appeal
  • Post claims appeals

Many payors may not be familiar with total contact casting, with regards to the supplies and frequency of the application, this may lead to challenges with claims adjudication and payment.

If you have questions regarding the coverage, coding and payment of total contact casting products, please contact the Derma Sciences Reimbursement Hotline at 1-800-474-9511 or submit your questions to

TCC-EZ® Product Coding:
Download TCC-EZ Produt Coding Form
Download Sample ICD-10 diagnosis codes PDF

Reimbursement Inquiry:

TCC-EZ® Forms:
Download PDF Sample TCC Sample Appeal Letter
Download PDF Sample TCC Authorization PHI Form
Download PDF DermaSciences Hotline Intake Form