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

This guidance covers Medicare billing for skin substitute grafts/CTP (non‑autologous human, xenograft, and biological scaffold products) for diabetic foot and venous leg ulcers per the LCD and excludes non‑graft wound dressings and injected substitutes, which are bundled and not separately payable. Key requirements: follow the LCD for medical necessity, use GY/GZ modifiers for non‑covered services, do not report HCPCS graft application codes with non‑graft dressings or CPT 97602, graft removal/cleansing/prep are included in application codes, and E/M may be billed only if a distinctly separate service was provided.