Tissue Engineered Skin Substitutes - (0068)

Cigna covers only the specific tissue‑engineered skin substitutes and related biologic/dural/mesh products and indications listed in the policy (e.g., select skin substitutes for noninfected diabetic foot and venous leg ulcers refractory to standard care, defined burn products, dural grafts, certain acellular dermal matrices for breast reconstruction/parotidectomy, and specified meshes for hiatal/paraesophageal repair) and considers use for any unlisted indication or many other products in the “Not Covered” table experimental/unproven. Coverage is contingent on product‑ and indication‑specific clinical criteria and documentation — e.g., prior failure of standard wound therapy, documented wound duration/size/depth and absence of infection/necrosis, adequate perfusion (palpable pedal pulse or ABI ≥0.70), HbA1c <12% for diabetic foot ulcers, adherence to specified application frequency limits (most limited to a set number of applications within 12 weeks), and correct CPT/HCPCS coding.