Reimbursement assistance, payment information, and coding on OASIS® Matrix products
A reimbursement associate can help you with:
Tips for Payer research
- Provides checklists to help facilitate insurance research. These checklists provide tips for determining coverage, securing prior authorization, determining reason for claim denial or underpayment, and preparing appeals
Prior authorization requirements
- Determines prior authorization requirements for qualified healthcare professional (QHP) to apply an OASIS Matrix product on specific patient
- Advises the QHP of the prior authorization submission steps
Patient verification form is the simplest way to confirm insurance coverage of OASIS Matrix for your patients. Download the form, fill it out in full and fax it in to receive a response in 48 hours or less.
Patient verification form [PDF]
How is OASIS Matrix most commonly reimbursed?
There are a lot of simple paths to reimbursement. Whether you’re operating out of a hospital (HOPD), Ambulatory Wound Center (ASC), or Physician In-Office (QHP), you’ll find links to download the payment forms below.
The American Medical Association has identified eight (8) Current Procedural Terminology (CPT) codes for the application of the OASIS Matrix products. Download them here.
2018 QHP Coding Information [PDF]
Information on reimbursement in the United States is provided as a courtesy. Due to the rapidly changing nature of the law and Medicare payment policy, and our reliance on information provided by outside sources, the information provided herein does not constitute a guarantee or warranty by Smith and Nephew, Inc. that reimbursement will be received.
This information is provided "AS IS" and without any other warranty or guarantee, expressed or implied, as to completeness or accuracy or otherwise. This information has been compiled based on data gathered from many primary and secondary sources, including the American Medical Association and certain Medicare contractors.
Physicians and other providers must confirm or clarify coding and coverage from their respective payers, as each payer may have differing formal or informal coding, coverage policies, or decisions. Physicians and providers are responsible for accurate documentation of patient conditions, and for reporting of procedures and products in accordance with particular payer requirements.
INTENDED USE: OASIS® Matrix is indicated for the management of wounds including: partial- and full-thickness wounds, pressure ulcers, venous ulcers, chronic vascular ulcers, tunneled and/or undermined wounds, diabetic ulcers, trauma wounds (abrasions, lacerations, second-degree burns, skin tears), draining wounds, surgical wounds (donor sites/grafts, post-Mohs’ surgery, post-laser surgery, podiatric, wound dehiscence).
CONTRAINDICATIONS: This device is derived from a porcine source and should not be used in patients with known sensitivity to porcine material.
This device is not indicated for use in third-degree burns.
PRECAUTION: OASIS® Matrix should not be applied until excessive exudate, bleeding, acute swelling, and infection are controlled.
POTENTIAL COMPLICATIONS: The following complications are possible. If any of these conditions occur, the device should be removed: infection, chronic inflammation (initial application of wound dressings may be associated with transient, mild, localized inflammation), allergic reaction, excessive redness, pain, swelling, or blistering.