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

This policy supplements LCD L39806 for skin substitute grafts/CTPs for diabetic foot and venous leg ulcers, clarifying that CPT-defined skin substitute grafts (non‑autologous human, non‑human, cellular/acellular sheet scaffolds) are billable but non‑graft wound dressings (gels, powders, ointments, foams) and injected skin substitutes are excluded from graft application codes and must not be billed together with graft/CTP HCPCS application codes. Key requirements: follow the LCD for medical necessity, use the appropriate Medicare modifier (GX for Part A voluntary ABN, GY for statutorily excluded Part B items, GA when a waiver/ABN was issued and denial is expected, or GZ when no notice was issued and denial is expected), and avoid incorrect bundling of non‑graft products.