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December 2016 Texas Medicaid Provider Procedures Manual

Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook : 2 Texas Medicaid (Title XIX) Home Health Services : 2.2 Services, Benefits, Limitations and Prior Authorization : 2.2.23 Wound Care Supplies or Systems

Wound care supplies and wound care systems are a benefit through Home Health Services when provided to clients in the home setting. Wound care supplies and wound care systems are designed to assist in the healing of wounds in conjunction with an individualized wound care therapy regimen prescribed by a physician.
Wounds are recognized as acute or chronic:
Skin ulcers represent the majority of chronic wounds. Skin ulcers include but are not limited to:
Venous ulcers—also known as venous insufficiency ulcers, stasis ulcers, or varicose veins, and are due to sustained venous hypertension, which results from chronic venous insufficiency or an impaired muscle pump.
Arterial insufficiency ulcers—ulcers caused by insufficient arterial flow resulting in ischemia and eventual necrosis. Atherosclerosis is the most common cause of arterial ulcers. Other arterial vascular diseases include vasospastic disease and vasculitis. Arterial ulcers are frequently found at the most distal point of arterial perfusion. No drainage is apparent unless the ulcer is infected.
Diabetic ulcers—skin lesions associated with clients with Type 1 and Type 2 diabetes mellitus. The majority of all amputations in diabetic clients are preceded by an infected ulcer.
Wound care includes:
Based on the specific type of wound, wound care may include:
Measurable signs of improved healing include:
First line wound care therapy may include the following:
Second line wound care therapy may include:

Texas Medicaid & Healthcare Partnership
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