Introduction

CTP Ordering Standard Operating Procedure (SOP)

1. Provider Notification

• ·The provider notifies the Wound Care Coordinator (WCC) of a potential patient for Cellular Tissue Product (CTP) application.

2. Medical Record Review

• · WCC reviews the medical record to ensure all Local Coverage Determination (LCD) requirements are met and documented.

3. Addressing Missing Requirements

• · If the Provider’s note is missing LCD requirements, WCC communicates this to the Provider and discusses steps to fulfill the LCD requirements.

4. Pre-Treatment Documentation

• · As soon as it is determined that the patient will be in the Accelerated Wound Healing Program, WCC completes the Graft Pre-Treatment Eligibility Form with diagnostic codes and submits it to the Intake Coordinator (IC).

5. Review and Documentation Upload

• · IC reviews the Graft Pre-Treatment Eligibility Form and uploads supporting documentation to the Billing Company:
• For Lucid Medical Solutions (LMS), use Teams: New Day Wound Care > General > PA Supporting Records.

6. Prior Authorization Process

• · LMS Prior Authorization Department responds to non-stat requests within 72 hours (about 3 business days).
• · LMS provides updates or requests for additional data to the IC via the shared mailbox.

7. Review of Systems Call

• · The week prior to the application, a recorded Review of Systems call is scheduled with the Provider, WCC, and IC.
• · During this call, the Provider orders CTP with the IC on the call.

8. Reorders

• · For reorders of CTP, the Provider notifies the IC to arrange delivery to the Provider’s home for the week of the application.

9. ABN Form completion

• · Intake Coordinator (eventually Administrative Assistant) to obtain B&E and estimator information from Billing Portal and complete ABN form.
• · Intake Coordinator will upload document (where?)
• · Provider to have patient sign ABN the week prior to application of CPT (week ahead so we can ensure the patient is ok with the potential cost of CPT prior to ordering?)

10. Day of Application

• · On the day of the CTP application:
• Provider reviews and signs the following forms:

• · CTP Consent Form
• · Provide patient with specific CPT information through Wound Source
• · The Provider returns the CTP packaging to the clinic.
• · Provider documents the CTP application, patient education, and communication with Home Health Nursing (HHN) in the Electronic Medical Record (EMR).