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A History of the Schreckengast Family:

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General measures of wound therapy program For all ulcers or wounds, the following components of a wound therapy program must include a minimum of all of the following general measures, which should either be addressed, applied, or considered and ruled out prior to application of NPWT: Application of dressings to maintain a moist wound environment, and Debridement of necrotic tissue if present, and Documentation of evaluation, care, and wound measurements by a licensed medical professional, and Evaluation of and provision for adequate nutritional status.

The member has been on a comprehensive diabetic management program, and Reduction in pressure on a foot ulcer has been accomplished with appropriate modalities. For venous insufficiency ulcers: The member has complications of a surgically created wound e.

See specifications of equipment and supplies in the Appendix.

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An NPWT pump and supplies is considered not medically necessary if one or more of the following contraindications are present: The presence in the wound of necrotic tissue with eschar, if debridement is not attempted; or Osteomyelitis within the vicinity of the wound that is not concurrently being treated with intent to cure; or Cancer present in the wound; or The presence of an open fistula to an organ or body cavity within the vicinity of the wound.

On a regular basis, directly assess the wound s being treated with the NPWT pump, and supervise or directly perform the NPWT dressing changes, and On at least a monthly basis, document changes in the ulcer's dimensions and characteristics.

Any measurable degree of wound healing has failed to occur over the prior month. Wound healing is defined as improvement occurring in either surface area length times width or depth of the wound. There must be documentation of quantitative measurements of wound characteristics including wound length and width surface areaor depth, serially observed and documented, over a specified time interval.

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The medical necessity of NPWT beyond 4 months will be given individual consideration based upon required additional documentation; or In the judgment of the treating physician, adequate wound healing has occurred to the degree that NPWT may be discontinued, or Once equipment or supplies are no longer being used for the member, whether or not by the physician's order; or When criteria under section on Continued Medical Necessity above, cease to be met.

Up to a maximum of 10 canister sets per month is considered medically necessary unless there is documentation showing a large volume of drainage greater than 90 ml of exudate per day.

For high volume exudative wounds, a stationary pump with the largest capacity canister must be used. Excess utilization of canisters related to equipment failure as opposed to excessive volume drainage is not considered medically necessary.

Staging of pressure ulcers used in this policy is as follows: Stage I Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blancing; its color may differ from the surrounding area.

Stage III Full thickness tissue loss.


Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining or tunneling. Stage IV Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed.

Often include undermining and tunneling. Aetna considers NPWT experimental and investigational for the following because its effectiveness for these indications has not been established not an all-inclusive list: For use following cardiac surgery e.

Single party sauerland

Aetna considers the use of non-powered mechanical NPWT devices e.Gmail is email that's intuitive, efficient, and useful. 15 GB of storage, less spam, and mobile access.

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At the middle level, Olpe is ecclesiastically administered by the Deanery of the South Sauerland, which was formed out of the former deaneries of Attendorn, Elspe and Olpe on 1 July , and is coëxtensive with the district of Olpe.

Schreckengast Family Folder. Online Material Published Sources Researchers. People researching this surname include: Gary Schreckengost. Biography "Startle a Guest!". Luxury lingerie from Agent Provocateur. Shop for exquisite lingerie, classic corsetry, sumptuous nightwear, striking hosiery, sensual beauty and playful accessories.

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