Skin and Tissue Substitutes - MEDICAID - LOUISIANA

This policy covers skin and tissue substitute products for management and reconstruction of wounds and tissue defects — including severe burns, diabetic and venous lower‑extremity ulcers, full‑thickness skin‑loss ulcers, surgical wounds, breast reconstruction, ocular defects and plantar fasciitis. Coverage is product‑ and indication‑specific and generally requires failure of ≥4 weeks of standard wound therapy, absence of bone/capsule/muscle/tendon exposure, adherence to product‑specific criteria (e.g., Apligraf, Dermagraft, Integra), and many listed HCPCS/product codes are expressly excluded; some benefits apply only to Healthy Horizons Louisiana members.

"Treatment of severe burns"

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