Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers
L39760
Covered: skin substitute grafts/CTPs with product‑specific clinical trial evidence of wound closure are covered as adjunctive therapy for chronic, non‑infected diabetic foot ulcers (DFU) and venous leg ulcers (VLU) that have failed to achieve >50% ulcer area reduction after at least 4 weeks of documented standard of care; products without sufficient evidence are excluded. Key requirements: documentation of SOC and patient compliance, adequate wound‑bed preparation and infection control, serial wound measurements, appropriate vascular/perfusion and venous testing (ABI/toe pressures/TcPO2, CEAP/VCSS/duplex as applicable), use of offloading for DFU and compression for VLU (modified for mixed disease), and use over exposed tendon/muscle/bone only if the product is labeled for that indication.
"Application of a skin substitute graft/CTP in the treatment of diabetic foot ulcers (DFU) when the patient meets all LCD criteria."