Skin and Soft Tissue Substitutes

Aetna covers specific skin/soft tissue substitutes only for listed indications: Alloderm/Alloderm‑RTU for breast reconstruction and selected surgical repairs (e.g., complex abdominal wall, tympanoplasty, skull base/temporal bone), cadaveric allogeneic skin grafts (AlloSkin) for traumatic/burn wounds too large for autograft, AlloPatch for neuropathic diabetic foot ulcers >6 weeks duration with no exposed capsule/tendon/bone when used with standard diabetic ulcer care, and AmnioBand for chronic venous leg ulcers refractory to ≥4 weeks of standard therapy and for diabetic foot ulcers >6 weeks without exposed structures when used with standard care. Aetna considers Alloderm experimental/investigational for other indications (e.g., hernia repair, Frey’s syndrome prevention, rectal fistula, upper‑extremity reconstruction), does not treat AlloSkin AC/RT or other variants as equivalent to the covered AlloSkin product, and deems Apligraft, Artiss, Biobrane and other unlisted uses experimental/investigational.