Billing and Coding: Skin Substitutes Grafts/Cellular Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers

Medicare billing guidance covers application of skin substitute grafts/CTPs (non‑autologous human, xenograft, and biologic sheet scaffolds) for diabetic foot and venous leg ulcers but excludes separate payment for non‑graft wound dressings or injected skin substitutes (those are bundled) and treats removal/simple cleansing and surgical prep as included in the application codes; active wound care code 97602 must not be billed with skin substitute application codes. Key requirements: follow the LCD for medical necessity, use GY/GZ modifiers when services are non‑covered, do not report non‑graft/injected HCPCS with graft/CTP application codes, and only bill an E/M if a separate, distinct service was provided.