LCD guidance for skin substitutes
Applies to wound treatments, skin substitutes (non-porcine based)
Last modified: Sept. 23, 2024
Update: We updated coverage summary to medical policy in the article. We also added a link to the frequently asked questions.
Medicare does not have a National Coverage Determination (NCD) for non-porcine based skin substitutes. Please refer to our Skin Substitutes Grafts/Cellular and Tissue-Based Products (Injections and/or Applications) medical policy which explains the coverage criteria and incorporates Local Coverage Determinations (LCDs)/Local Coverage Articles (LCAs). As a reminder, services provided to UnitedHealthcare® Medicare Advantage members in jurisdictions with LCDs/LCAs will only be considered medically necessary in those jurisdictions when consistent with the applicable LCDs/LCAs.
Review state-specific LCDs/LCAs in the following table:
|
Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities (L36690) |
|
Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds (L35041) |
|
Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities (L36377) |
Questions?
For additional information, see our Skin substitutes wound treatments: Medicare Advantage and Dual Special Needs Plans frequently asked questions.
PCA-1-24-02749-Clinical-NN_09202024
