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Endoform Dermal Template Dressing, 5 cm x 5 cm, 10/box

Endoform Dermal Template Dressing is a collagen dressing. INTENDED USES: Can be used to treat chronic wounds from day one. CLAIMED FEATURES: Material - 90% Native,Intact Collagen /10% Extracellular Matrix Components UNSPSC Code 42311604. Features Broad spectrum MMP reduction. May be reapplied as infrequently as once per week. OPTIONS: 5 cm x 5 cm, 10/box

Product Information

Collagen Dressings contain collagen, the protein that gives the skin its tensile strength and is a key element in the process of wound healing. Collagen Dressings are especially indicated for deeper wounds and wounds that stopped healing despite good wound care. It is not indicated for wounds with large amounts of black, dry scabs, infection, or high amounts of fluid, and should not be used in persons with sensitivity to bovine (cattle), porcine (swine), or avian (bird) products. Collagen dressings come in pads, gels or particles. They can stay in place up to 7 days, depending on the specific product.

Center for Medicare and Medicaid Services (CMS). Local Coverage Determination for Surgical Dressings (L33831) [Internet]. 2016 [cited 2017 Apr 30].



Pricing and Suppliers

Is it covered by Medicare Part B?

Medicare Part B (Medical Insurance) covers specific types of dressings, such as collagen dressings, that are considered medically necessary for treatment of a surgical or surgically treated wound which meets specific requirements. Medicare has guidelines that establish what is considered medically necessary and how often an item can be used.

Center for Medicare and Medicaid Services (CMS). Local Coverage Determination for Surgical Dressings (L33831) [Internet]. 2016 [cited 2017 Apr 30].

How can I purchase this product?

If you have coverage through Medicare Part B, you may be eligible to have this product covered by Medicare. You will need a written order prescribed by a provider enrolled in Medicare, so that you can purchase this product at a Durable Medical Equipment store that accepts Medicare. You will need to pay deductibles and co-payment. The actual co-payment amount varies according to your state. If you do not have Medicare Part B or do not meet the requirements needed for coverage, you can find this product at pharmacies and medical supply stores. When available, please see pricing in "Other Stores" below.

The table below shows highest and lowest Medicare pricing across the country
DescriptionMedicare DME co-payment Min / Max
Collagen dressing, sterile, size 16 sq. in. or less, each $4.11 / $4.84

The Medicare website indicates that the 3 stores in below carry "" and accept Medicare. However, PRODUCT MAY NOT BE AVAILABLE IN STORE. If using private insurance, please check if your insurance works with these stores.

SAFEWAY INC
15 MARINA BLVD
SAN FRANCISCO, CA 94123
(415)563-8681
WALGREEN CO
2141 CHESTNUT ST
SAN FRANCISCO, CA 94123
(415)567-9320
WALGREEN CO
3201 DIVISADERO ST
SAN FRANCISCO, CA 94123
(415)931-6417
Recommended Suppliers
Estimated out-of-pocket cost: $152.80

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=387

Other Stores

StorePriceAccepts
Medicare*
Accepts
Insurance*
ShippingWebsitePhone
Amazon$152.80 Inquire vendor Inquire vendor Free with Prime www.amazon.com  
* 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.