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

Medicare covers skin substitute grafts/CTP for diabetic foot and venous leg ulcers only when they meet the LCD L39865 reasonable‑and‑necessary criteria, and non‑graft wound dressings or injected skin substitutes are not billable with skin substitute graft application codes (they are typically bundled or excluded). Providers must follow the LCD documentation/medical‑necessity rules, use CPT definitions (report application codes only for sheet grafts), and apply the appropriate GA/GX/GY/GZ modifiers when billing for services expected to be non‑covered.