Burn Surgery

This policy covers burn surgery including early debridement/excision and wound coverage with autograft (preferred) or, when autograft is not feasible, allografts, porcine xenograft, and specified FDA‑approved/tissue‑engineered skin substitutes (examples: Biobrane, Transcyte, Apligraf, TheraSkin, Integra; Epicel only per its HDE) for acute deep partial‑thickness, full‑thickness, and severe burns (such as >20% TBSA, inhalation injury, chemical/high‑voltage electrical burns, circumferential burns, burns to high‑risk areas, or burns in high‑risk patients) requiring specialty burn‑center care. Limitations: autograft is the standard of care and substitutes are covered only when autograft is unavailable/infeasible; coverage is limited to the acute phase, excludes use with active infection, necrotic/ischemic graft beds or insufficient perfusion (unless vascularized coverage provided), and is restricted to products/uses consistent with FDA indications.

"Early burn debridement/excision for acute burns to improve survivability and outcomes."