👨‍⚕️ For Healthcare Professionals

Physician FAQ

Common questions about collagen wound dressings, reimbursement, and clinical protocols

💰 Reimbursement & Insurance Coverage

How do I get reimbursed for collagen wound dressings?

Collagen dressings are reimbursed using specific HCPCS codes:

  • A6010 - Collagen based wound filler, powder, per gram
  • A6021 - Collagen dressing, sterile, pad size ≤16 square inches
  • A6210 - Collagen dressing, sterile, pad size >16 but ≤48 square inches

Medicare Part B covers collagen dressings when medically necessary with proper documentation. Most commercial insurers follow Medicare guidelines. Our reimbursement team can help with specific carrier questions.

What is the typical reimbursement rate?

Medicare allowable rates vary by region but typically range from $8-$15 per sheet depending on size. CollagenDirect reports a 98% reimbursement success rate when proper documentation is provided. We handle all insurance verification and prior authorization if needed.

Does Medicare cover collagen dressings?

Yes, Medicare Part B covers collagen dressings for chronic wounds when:

  • • Medically necessary for wound healing
  • • Used on Stage II-IV pressure ulcers, diabetic ulcers, venous stasis ulcers
  • • Prior standard wound care has been attempted
  • • Proper documentation is maintained

We ship directly to patients and handle all Medicare claims processing for you.

What about commercial insurance and Medicaid?

Most commercial insurers (UnitedHealthcare, Aetna, Cigna, Blue Cross Blue Shield) cover collagen dressings following Medicare guidelines. Medicaid coverage varies by state but is generally available. Our insurance verification team checks coverage before shipping and handles all prior authorizations.

📋 Documentation Requirements

What documentation is required for insurance coverage?

Required documentation includes:

Initial Assessment:

  • • Wound measurements (L×W×D)
  • • Wound classification & stage
  • • Location and laterality
  • • ICD-10 diagnosis code
  • • Photo (recommended)

Treatment Plan:

  • • Product selection rationale
  • • Change frequency
  • • Expected outcomes
  • • Failed prior treatments
  • • Follow-up schedule

How often do I need to document wound progress?

Document wound status at each dressing change or at minimum weekly. Include:

  • • Updated wound measurements
  • • Changes in wound appearance (granulation, epithelialization, necrotic tissue)
  • • Exudate type and amount
  • • Signs of infection or complications
  • • Patient tolerance and adherence

Do I need prior authorization?

Prior authorization requirements vary by insurance carrier. CollagenDirect handles all prior authorization requests on your behalf. Our portal flags which patients require PA, and our reimbursement specialists manage the entire process. Typical approval time is 3-5 business days.

🏥 Clinical Protocols & Best Practices

How often should collagen dressings be changed?

Change frequency depends on wound exudate level and product type:

Product Type Change Frequency
Collagen Sheets (low exudate) Every 3-7 days
Collagen Sheets (moderate/heavy exudate) Every 1-3 days
Collagen Powder Every 1-7 days
Silver Hydrogels Every 3-7 days

Note: Always change dressing when saturated or if strike-through occurs.

Can I use collagen dressings with compression therapy?

Yes! Collagen dressings are fully compatible with compression therapy for venous leg ulcers. Application sequence:

  1. 1. Clean and debride wound as indicated
  2. 2. Apply collagen dressing directly to wound bed
  3. 3. Cover with secondary dressing (foam or gauze)
  4. 4. Apply compression bandaging per protocol

Compression therapy is essential for venous ulcer healing and does not reduce collagen efficacy.

Should I debride before applying collagen?

Yes, debridement of non-viable tissue is recommended before collagen application for optimal results. Collagen dressings work best on clean wound beds with minimal necrotic tissue or slough. Acceptable debridement methods include:

  • • Sharp/surgical debridement
  • • Enzymatic debridement
  • • Autolytic debridement (collagen helps facilitate this)

Are there any contraindications for collagen dressings?

Contraindications include:

  • • Known sensitivity to bovine collagen or product components
  • • Third-degree burns
  • • Wounds with active untreated infection (use antimicrobial options instead)
  • • Dry/eschar-covered wounds without adequate moisture

Use with caution: Patients with known allergies to beef or beef products.

Can collagen be used with negative pressure wound therapy (NPWT)?

Yes, collagen dressings can be used as a contact layer under NPWT foam. Apply collagen directly to wound bed, then place NPWT foam and seal per device instructions. This combination may enhance granulation tissue formation. Change collagen dressing per NPWT dressing change protocol (typically every 2-3 days).

🎯 Product Selection Guide

Which collagen product should I use for different wound types?

Collagen Sheets (2×2, 4×4)

Best for:

  • • Flat, shallow wounds
  • • Pressure ulcers (Stage II-IV)
  • • Diabetic foot ulcers
  • • Venous leg ulcers
  • • Surgical wounds

Collagen Powder

Best for:

  • • Irregular wound shapes
  • • Tunneling wounds
  • • Undermined wounds
  • • Cavity wounds
  • • Deep wounds with irregular bases

Silver Hydrogel

Best for:

  • • Infected or critically colonized wounds
  • • Wounds at high risk of infection
  • • Dry to moderately exuding wounds
  • • Burns (first and second degree)

Alginate Dressings

Best for:

  • • Moderate to heavily exuding wounds
  • • Wounds requiring hemostasis
  • • Cavity wounds with heavy drainage

How do I choose the right size?

Select a dressing size that extends at least 1-2 cm beyond the wound edge to ensure full coverage and adherence. For irregular wounds, choose the next size up or use collagen powder. Common sizes:

  • • 2×2 (5cm × 5cm) - Small wounds <4 sq inches
  • • 4×4 (10cm × 10cm) - Medium wounds 4-16 sq inches
  • • Powder (1g) - Any irregular or cavity wound

📦 Ordering & Delivery

How do I order products for my patients?

Order through our physician portal at collagendirect.health/portal:

  1. 1. Add patient - Enter demographics and insurance information
  2. 2. Create order - Select products, document wound details, ICD-10 codes
  3. 3. Submit - We handle insurance verification and prior auth
  4. 4. Delivery - Products ship directly to patient within 3-5 business days

How quickly are products delivered?

Most orders ship within 24-48 hours of approval. Standard delivery is 3-5 business days. Expedited shipping available for urgent cases. Patients receive SMS and email notifications with tracking information.

Can patients order refills themselves?

No, all orders require physician authorization through our portal. However, we send refill reminders to you based on the treatment frequency you specify, making it easy to approve ongoing therapy with one click.

What if a patient's insurance changes?

Simply update the patient's insurance information in the portal. Our team will re-verify coverage and process any new prior authorizations needed. We'll notify you if there are any coverage issues.