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Endoform Dermal Template

Endoform Dermal Template

Endoform Dermal Template

Technology and Product Assessment
Product Type: Collagen
Other related products
Unbiased information for educational purposes only. WoundReference does not produce, market, advertise, re-sell or distribute healthcare goods or services consumed by, or used on patients.
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
Manufacturer: Hollister Incorporated - Wound Care
Information retrieved from manufacturer and/or FDA-approved labels
* Wound Reference does not produce, market, re-sell or distribute health care goods or services consumed by, or used on, patients. The product information contained on this page, including the product images and additional product materials, was collected from various supplier sources. All product claims and specifications are those of the product suppliers. Every effort has been made to ensure the accuracy of the product information, however on occasion manufacturers may alter their products or packaging without notice. Wound Reference assumes no liability for inaccuracies or misstatements about products. The properties of a product may change or be inaccurate following the posting or printing of the product information in the document, either in the print or online version. Due to product changes, information listed in this document is subject to change without notice. We recommend that you always read labels, warnings and instructions for use before using a product. Content on this site is for reference purposes and is not intended to be a substitute for professional advice given by a physician or other licensed healthcare professional.

ESSENTIALS

Product
Estimated
Out-of-pocket
Cost
HCPCS Class
HCPCS
Endoform Dermal Template Dressing, 5 cm x 5 cm, 10/box
Collagen dressing, sterile, size 16 sq. in. or less, each
A6021
Endoform Dermal Template Dressing, 5 cm x 5 cm fenestrated, 10/box
Collagen dressing, sterile, size 16 sq. in. or less, each
A6021
Endoform Dermal Template Dressing, 10 cm x 12.7 cm, 10/box
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each
A6022
Endoform Dermal Template Dressing, 10 cm x 12.7 cm fenestrated, 10/box
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each
A6022
* Hover on the information button next to each header for detailed explanation on the type of information provided by the table
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DME coverage and co-payment
Product
Estimated
Out-of-pocket
Cost
Patient DME Co-Payment per Billable Unit
DME Reimbursement to Suppliers
Frequency Replacement if Requirements Met
Office and/or Facility - Product reimbursement
Endoform Dermal Template Dressing, 5 cm x 5 cm, 10/box
Hollister Incorporated - Wound Care
Endoform Dermal Template Dressing, 5 cm x 5 cm, 10/box
$4.84
each
$24.20
1 changes/week
Endoform Dermal Template Dressing, 5 cm x 5 cm fenestrated, 10/box
$4.84
each
$24.20
1 changes/week
Endoform Dermal Template Dressing, 10 cm x 12.7 cm, 10/box
$4.84
each
$24.20
1 changes/week
Endoform Dermal Template Dressing, 10 cm x 12.7 cm fenestrated, 10/box
$4.84
each
$24.20
1 changes/week
* Every effort has been made to ensure the accuracy of the product information, however you should visit the manufacturer's website for the latest information.
* Hover on the information button next to each header for detailed explanation on the type of information provided by the table
Product
Estimated
Out-of-pocket
Cost
Features
Endoform Dermal Template Dressing, 5 cm x 5 cm, 10/box
Application: Can be used as primary dressing Depth: Full thickness (deep) Depth: Partial thickness (shallow) Exudate: Low Exudate: Moderate Exudate: High Indications: May be applied over infected tissue Indications: May be used to pack deep wounds Indications: May be used under compression Medicare freq of replacement: 1/week Wear time: Up to 7 days
Endoform Dermal Template Dressing, 5 cm x 5 cm fenestrated, 10/box
Application: Can be used as primary dressing Depth: Full thickness (deep) Depth: Partial thickness (shallow) Exudate: Low Exudate: Moderate Exudate: High Indications: May be applied over infected tissue Indications: May be used to pack deep wounds Indications: May be used under compression Medicare freq of replacement: 1/week Wear time: Up to 7 days
Endoform Dermal Template Dressing, 10 cm x 12.7 cm, 10/box
Application: Can be used as primary dressing Depth: Full thickness (deep) Depth: Partial thickness (shallow) Exudate: Low Exudate: Moderate Exudate: High Indications: May be applied over infected tissue Indications: May be used to pack deep wounds Indications: May be used under compression Medicare freq of replacement: 1/week Wear time: Up to 7 days
Endoform Dermal Template Dressing, 10 cm x 12.7 cm fenestrated, 10/box
Application: Can be used as primary dressing Depth: Full thickness (deep) Depth: Partial thickness (shallow) Exudate: Low Exudate: Moderate Exudate: High Indications: May be applied over infected tissue Indications: May be used to pack deep wounds Indications: May be used under compression Medicare freq of replacement: 1/week Wear time: Up to 7 days
No CPT codes to display.
  • Hover on the information button next to each header for detailed explanation on the type of information provided by the table
  • The information provided on this website is informational only. This is not a guarantee of Reimbursement Rates, nor is it intended to make recommendations regarding clinical practices. Information on this website is subject to change with out notice due to changes in reimbursement laws, regulations, rules and policies. The ultimate responsibility for correct coding lies with the provider of services. Please contact the appropriate payer for their interpretation of the appropriate code to use for the procedure.
  • CPT® is a registered trademark of the American Medical Association. All CPT codes and descriptions are copyrighted 2018, American Medical Association. All rights reserved. CPT codes and CPT descriptions are from the current manuals and those included herein are not intended to be all-inclusive and are included for informational purposes only. Codes referenced on Wound Reference are for informational purposes only. Inclusion or exclusion of any codes does not guarantee coverage. Providers should reference the American Medical Association prior to the submission of claims for reimbursement of covered services.
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CLINICAL

Indications

For single use in the treatment of the following wounds: partial and full-thickness wounds; pressure ulcers; venous ulcers; diabetic ulcers; chronic vascular ulcers; tunneled/undermined wounds; surgical wounds (donor sites/grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence); trauma wounds (abrasions, lacerations, second-degree burns, and skin tears); draining wounds.

FDA

EndoForm Dermal Template (Mesynthes, Ltd., North Attleboro, MA, USA, and Wellington, New Zealand) was cleared for marketing under the 510(k) process (K092096) in January 2010. EndoForm Dermal Template is included in FDA product code KGN (dressing, wound, collagen)

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NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.
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