Billing and Coding: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities

Skin substitute graft application codes apply to non-autologous dermal/epidermal grafts, xenografts, and biological sheet products used to treat DFU and VLU of the lower extremities when reasonable and necessary per LCD L36377. Documentation must fully support diagnosis, procedure, product identity (including package/lot information), wound size/status pre- and post-treatment, and accounting for units used/discarded; the first application initiates a 12-week episode of care and CPT 97602 should not be reported with skin replacement surgery codes.

"Application of skin substitute grafts is covered for treatment of diabetic foot ulcers (DFU) and venous leg ulcers (VLU) of the lower extremities when reasonable and necessary per LCD L36377."

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