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Tissue-Engineered Skin Substitutes

Page 1 of 159 Medical Coverage Policy: 0068 Medical Coverage Policy Effective Date .. 11/15/2022 Next Review Date .. 3/15/2023 Coverage Policy Number .. 0068 Tissue-Engineered skin Substitutes Table of Contents Overview .. 1 Coverage Policy .. 1 General Background .. 24 Medicare Coverage Determinations .. 109 Coding Information .. 110 References .. 117 Related Coverage Resources Autologous Platelet Derived Growth Factors (Platelet-Rich Plasma [PRP]) Bone, Cartilage, Ligament Graft Substitutes Breast Reconstruction Following Mastectomy or Lumpectomy Electrical Stimulation Therapy and Devices in a Home Setting Hyperbaric & Topical Oxygen Therapies Injectable Fillers Lumbar Fusion for Spinal Instability and Degenerative Disc Conditions, Including Sacroiliac Fusion Negative Pressure Wound Therapy/Vacuum-Assisted Closure (VAC) for Nonhealing Wounds Plantar Fasciitis Treatments Sc

This Coverage Policy addresses tissue engineered skin substitutes and the various proposed indications for their use in multiple conditions. Coverage Policy . Each of the following skin grafts is considered medically necessary for wound closure: • …

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