RevoShield Amniotic Barrier

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RevoShield Amniotic Barrier, Per Square Centimeter

RevoShield Amniotic Barrier is a minimally manipulated dual layer tissue-based product derived from the amniotic membrane of the human placenta

INTENDED USES: The intended use of the RevoShield Amniotic Barrier is to serve as a barrier or to provide protective coverage from the surrounding environment for acute and chronic wounds.

CLAIMED BENEFITS: Amniotic membrane grafts contain cytokines and growth factors which have been demonstrated to enhance chronic

wound healing.

OPTIONS: Per Square Centimeter

RBA2008FD-S: RevoShield Amniotic Barrier, Single Layer, 4x4cm: Q4289

RBA2010FD-S: RevoShield Amniotic Barrier, Single Layer, 4x6cm: Q4289

RBA2012FD-S: RevoShield Amniotic Barrier, Single Layer, 4x8cm: Q4289

RBA2009FD: RevoShield Amniotic Barrier, Dual Layer, 2x2cm: Q4289

RBA2006FD: RevoShield Amniotic Barrier, Dual Layer, 2x3cm: Q4289

RBA2007FD: RevoShield Amniotic Barrier, Dual Layer, 3x4cm: Q4289

RBA2008FD: RevoShield Amniotic Barrier, Dual Layer, 4x4cm: Q4289

RBA2010FD: RevoShield Amniotic Barrier, Dual Layer, 4x6cm: Q4289

RBA2012FD: RevoShield Amniotic Barrier, Dual Layer, 4x8cm: Q4289

RBA2014FD: RevoShield Amniotic Barrier, Dual Layer, 10x15cm: Q4289

Product Information

The addition of Skin Substitutes or Cellular or Tissue Based Products (CTPs) to certain wounds may afford a healing advantage over dressings and conservative treatments when these options appear insufficient to affect complete healing, after at least a 30 day period of comprehensive conservative therapy. There are currently a wide variety of bioengineered products available for soft tissue coverage to affect closure. • Human skin allografts are derived from donated human skin (cadavers) • Allogeneic matrices are derived from human tissue (fibroblasts or membrane) • Composite matrices are derived from human keratinocytes, fibroblasts and xenogeneic collagen • Acellular matrices are derived from xenogeneic collagen or tissue

Pricing and Suppliers

Is it covered by Medicare Part B?

Medicare covers the application of Cellular and Tissue Based Products (CTPs) for chronic Wounds, which are defined as wounds that do not respond to standard wound treatment for at least a 30 day period during organized comprehensive conservative therapy. Medicare has guidelines that establish what is considered medically necessary and how often an item can be used.

How can I purchase this product?

For Medicare to cover this product, it needs to be ordered and applied by your clinician. A patient cannot purchase it directly from a Durable Medical Equipment (DME) store and receive reimbursement for it.

The table below shows highest and lowest Medicare pricing across the country

Description	Medicare DME co-payment Min / Max
	$0.00 / $0.00

Estimated out-of-pocket cost:

If your insurance does not cover this product, you can purchase it directly from any store. A list of online stores and prices is provided below for your convenience. For updated prices, find it on the internet at https://woundreference.com/app/product?id=3342

Other Stores

* Indicates whether store accepts Medicare or commercial insurance, but may not apply to this specific product. See coding, coverage and reimubursement for more information.

The information on this handout is for your convenience and educational purposes only. All product claims and specifications are those of the product suppliers. It does not constitute medical advice or a guarantee for reimbursement. Prices may have changed and suppliers may not have product in stock. Please confirm accuracy and appropriateness of information with insurance carrier and product supplier. Clinician and WoundReference assume no liability for inaccuracies or misstatements about products and insurance coverage.