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Needed: Designated CPT & HCPCS Codes



Help us Help you - Write to AMA and CMS to support the establishment of CPT and HCPCS codes straight away
The American Medical Association (AMA) will soon decide whether or not to issue a procedure (CPT) code for maggot therapy. The Centers for Medicare & Medicaid Services (CMS) will similarly decide whether or not to issue a product (HCPCS) code for medicinal maggots. Read and share this information with your friends and colleagues, and then consider supporting our request to CMS and AMA to issue medical codes for medicinal maggots and maggot therapy.

Research funded in the 1990s by AARP, Paralyzed Veterans of America and the American Paraplegia Society demonstrated that maggot therapy was safe, effective, and faster than conventional treatments for treating many diabetic foot ulcers, pressure ulcers, and other non-healing wounds. Maggot therapy saved limbs from amputation and was associated with a fewer complications. Based on the results of these studies, medicinal maggots were given full marketing clearance by the FDA and are now regulated as a prescription-only medical device.

What are CPT and HCPCS CODES? current procedural terminology (CPT) Codes are established by the American Medical Association (AMA) to codify all medical treatments and procedures. CPT codes are used by every health care provider and institution to identify treatments given on reporting and insurance forms. Healthcare Common Procedure Coding System (HCPCS) codes include the medical items used in those procedures, such as bandages, dressings, and medical equipment. HCPCS and CPT codes are used to track treatments, supplies, and to request reimbursement.

Why are HCPCS and CPT codes important for patients and therapists wanting maggot therapy? Last year there were fewer than 1,000 therapists in the U.S. providing maggot therapy for their patients. In Europe, over 40,000 maggot treatments were used last year to treat serious wounds and save limbs from amputation. In the U.S., only 2,000 maggot treatments were distributed, but nearly 80,000 amputations were performed. A recent survey by the University of California and the BTER Foundation identified the most common reason cited by therapists for not using maggot therapy was the inability to request reimbursement (due to lack of CPT and/or HCPCS codes).

Why does maggot therapy not have a code of its own? One reason may be that maggots are not a money-making medical device, and there is no affluent commercial supporter to lobby on their behalf. The BioTherapeutics, Education & Research (BTER) Foundation is requesting again this year that the AMA Committee on CPT Coding designate a CPT code for maggot therapy, and that CMS issue a product code for medical grade maggots.

Please consider supporting us in this effort.

Please write to us, to CMS, and/or to the AMA (adresses below) to let them know if you believe that maggot therapy should be available to patients like any other legally marketed, FDA-regulated medical treatment. Let them know that maggot therapy is sufficiently different from other treatments in terms of labor and materials that it deserves its own procedure and product codes.

AMA CPT Coding Committee Address:
American Medical Association
Department of CPT Editorial Research and Development
515 N State St.
Chicago, IL 60610

CMS Address:
Medicaid HCPCS Coordinator
Centers for Medicare & Medicaid Services
Mail Stop S2-01-16
7500 Security Boulevard
Baltimore, MD 21244-1850

BTER Foundation Address:
BioTherapeutics, Education & Research Foundation
36 Urey Court
Irvine, CA 92617
Fax: 949-679-3001
E-mail: RSherman@BTERFoundation.org


Sample letters to AMA and CMS - how to write your own -
Letters supporting the establishment of a CPT code for maggot therapy should be addressed to the AMA (see above) and should strees the facts that maggot therapy is practiced wides, throughout the U.S. and it requires more time and resources (dressing materials) than other forms of non-surgical debridement, and therefore deserves a designated code of its own.

Letters supporting the establishment of a HCPCS code for medicinal maggots should be addressed to CMS (see above) and should strees the facts that maggot therapy is practiced widely, is much less expensive than alternative modalities (especially compared to surgery or amputation) but is expensive enough --- as expensive as the procedure itself --- to deserve a product code of its own.


Letters from the BTER Foundation to AMA and CMS
The following links will take you to the letter written by The
BTER Foundation to the AMA, in support of a CPT code for maggot therapy, and a copy of the letter written by The BTER Foundation to CMS, in support of a HCPCS code for medicinal maggots.



"The BeTER Foundation"
36 Urey Court;   Irvine,  CA   92617
Phone: 330-644-0217;     Fax: 949-509-7040
E-mail: info@BTERFoundation.org
www.BTERFoundation.org