Maggot Therapy in News and TV

• By sallysmart
• Posted December 29, 2008 at 10:50 am
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You didn't say but I am assuming you mean for treating ulcers or sores on the feet,,, I will try to make sure I see this show, thanks for the notice on it.

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• By MaggotLady
• Posted December 29, 2008 at 11:47 am
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I used it for non-healing ulcers on my feet BUT they can be used for any non-healing wound. Plus gangrene, pressure ulcers, infected burns, MRSA, etc.
So many people and doctors have no idea all that maggots can do. Eat just the dead infected tissue (not the good like surgery does when they cut out infection) excrete enzymes to promote healing, and kill all the bacteria at the same time. Plus they can work on bone to heal osteomyelitis like they did for me. Amazing little guys those maggots. The show is on the ten top medical trends for 2009 but they just did a very small interview with me while showing my pic's. BUT hey anything that helps someone out is a beginning.

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• By Globalwoundcare
• Posted March 1, 2009 at 5:23 pm
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We have used maggots many time to treat patients at Global Wound Care. We even have an employee we call the maggot girl who in charge of getting rid of the maggots. She has gotten so good at it that frequently our doctors will let her pack the maggots in the wound. The main problem with maggots is keeping them in the wound. We usually use women' stockings over the dressing. It may take one or three applications, because you have to remove the maggots after 3 days. People always worry that the maggots will get lost and travel deeper than the wound. It just is not going to happen. To my understanding maggots, once fed, are looking for soil or they can become flies. If no dirt, the maggots will die. When flushing the maggots out of wound, you may see both dead and live maggots. Three hundred maggots cost me about $100. Medicare reimbusement barely covers the cost., so that is why so many doctors avoid maggots. It is tough to provide therapy that insurnce companies won't pay, it will eventually put you out of practice, and then you can not help anyone.

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• By RSherman
• Posted March 2, 2009 at 7:43 am
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Interesting conversation; thank you for the discussion.
Glad to see that some therapists (Globalwoundcare) are doing maggot therapy despite their financial concerns. I would like to add encouraging information that addresses two of the issues raised: fear of escaping maggots, and concern over poor reimbursement.

Regarding escaping maggots - If nylon stockings are being used as dressings, then there will occasionally be escaping maggots because the smallest maggots will be able to squeeze through the holes. What is needed is a fabric with pore size no larger than 150 microns, with fibers that are fixed in position (do not move or stretch). Fortunately, a couple medical products made in this way and specifically designed for this purpose are now, or soon will be, available on the market.

Regarding insurance or Medicare coverage - Reimbursement is actually better than many believe. With FDA marketing clearance for maggot therapy, with AMA publicizing their maggot therapy coding guidelines (Sept, 2008) and with Medicare including maggot therapy in their web-based guidance document for wound treatment options, it would be hard for any insurance provider to deny reimbursement. Some still do, out of ignorance, especially if it is their first claim. But appeals are usually won (did you know that nearly 50% of ALL Medicare appeals are won!). Indeed, the most common reason for non-reimbursement is: not applying.

The BioTherapeutics, Education & Research (BTER) Foundation (with which I am affiliated) provides grants for patients without insurance, or whose insurance refuses to pay for maggots. So even if the insurance company does not pay for the maggots, our charity will usually be able to cover the cost for you; so there is no reason to deny treatment, and no reason to fear that the $100 cost of the maggots will break the bank of the therapist or patient. What we have learned through this grants program is that very few insurers actually decline payment (or else none of the eligible people are taking advantage of this grant) because our grantees account for much less than 1% of all maggot-treated patients in the U.S.

One last caveat: May years ago, before medicinal maggots even had FDA marketing clearance, I requested pre-approval from Medicaid to admit and treat a patient in order to administer maggot therapy under close observation. Though the initial request ("treatment authorization request") was denied, my appeal resulted in approval and full coverage for a two-week hospital stay (more than enough time) for a trial of maggot therapy. Now, hospitalization usually is not required for maggot therapy; and for most hospitalized patients who require maggot therapy, reimbursement isn't really even a concern. But for those patients (usually out-patients) for whom it might be a concern, full reimbursement should be requested, and all rejections should be appealed. If this $20,000 bill for elective hospitalization was paid, most claims for a $100 bottle of maggots are likely to be paid, too.

The BTER Foundation soon will offer an "Appeals Assistance Program" (as soon as we can raise the needed funds) in order to assist therapists and patients with claim denials, should they still occur. With each request for insurance coverage, non-paying insurers will find it much more difficult to defend their medically, legally and financially unsound decisions.

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• By MaggotLady
• Posted March 3, 2009 at 9:39 am
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Great answer Ron!! It is a good thing to get new and accurate info out there. That way maggot therapy will be offered more and more to people who are desperate to save their limbs and lives. Thanks!!!

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