Skin and Tissue Substitutes - Medicare Advantage

This policy covers skin and tissue substitutes (including acellular and cellular dermal matrices such as Cohealyx, MiroDry, and Mirragen) for management and reconstruction of wounds, including full‑ and partial‑thickness wounds, pressure, surgical and trauma wounds, and specifically chronic lower‑extremity ulcers such as diabetic foot ulcers (DFU) and venous leg ulcers (VLU). Coverage and medical necessity are determined per Medicare LCDs (e.g., L36377, L35041), generally limited to chronic non‑healing lower‑extremity wounds, subject to MAC jurisdictional variations and Medicare “reasonable and necessary” requirements, and may not cover separate home application.

"Cohealyx Collagen Dermal Matrix: Draining wounds"

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