LCD for Human Skin Equivalent (HSE) (L1944)

 

Contractor Information

Contractor Name 

BlueCross BlueShield of Tennessee (Riverbend Government Benefits Administrator) 

Contractor Number 

00390 

Contractor Type 

FI 

 

LCD Information

LCD ID Number 

L1944 

 

LCD Title 

Human Skin Equivalent (HSE) 

 

Contractor's Determination Number 

L1944 

 

AMA CPT / ADA CDT Copyright Statement 

CPT codes, descriptions and other data only are copyright 2007 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.  

 

CMS National Coverage Policy 

Title XVIII of the Social Security Act, Section 1862 (a)(1)(A). This section excludes coverage of items or services that are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Title XVIII of the Social Security Act, Section 1833 (e). This section prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

CMS Transmittal No. A-00-36, June 2000, details Hospital Outpatient Prospective Payment System (OPPS) implementation instructions.

CMS Transmittal No. B-01-07, Change Request 1521, February 2001, provides billing instructions for Apligraf.

CMS Transmittal No. B-00-30, May 2000, clarifies billing instructions carrier contractors for cultured skin graft products, including Apligraf. 

 

Primary Geographic Jurisdiction 

New Jersey
Tennessee
 

 

Secondary Geographic Jurisdiction 

Alaska
Alabama
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California
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Connecticut
Florida
Georgia
Hawaii
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Tennessee
Texas
Utah
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Vermont
Washington
Wisconsin
West Virginia
Wyoming
 

 

Oversight Region 

Region IV
 

 

 

Original Determination Effective Date 

For services performed on or after 09/29/2002  

 

Original Determination Ending Date 

 

 

Revision Effective Date 

For services performed on or after 01/25/2008  

 

Revision Ending Date 

 

 

Indications and Limitations of Coverage and/or Medical Necessity 

Human skin equivalents are biosynthetic and/or tissue-engineered living skin substitutes that have evolved from the traditional allograft. Availability and safety concerns associated with autogenic and allogeneic skin grafts have prompted the search for a more widely available biologic product, with structural and functional properties as close as possible to those of natural skin. The increasing attention to skin grafts is based, in part, on the graft's function of compensating for tissue loss by acting as an occlusive dressing, as a skin replacement, and as a stimulus for healing. Bioengineered tissue provides a matrix for cell migration and delivers growth factors to the wound bed.

The Least You Need to Know

This article covers the use of Apligraf and Dermagraft as well as any equivalent products yet to be released.

Dermagraft and Apligraf are both covered for neuropathic diabetic foot ulcers of at least six weeks duration if they have not responded to 4 weeks of intensive conventional conservative therapy. The ulcers must be located on the plantar, medial or lateral surfaces of the foot. A 12 week (or longer) period of treatment is covered, which can include up to 3 applications of Apligraf or 8 of Dermagraft. Retreatment of the same ulcer within a year is not covered.

Apligraf is covered for venous stasis ulcers of at least four weeks duration if they have not responded to 4 weeks of intensive conventional conservative therapy. A 12 week (or longer) period of treatment is covered, which can include up to 3 applications of Apligraf. Retreatment of the same ulcer within a year is not covered.

As these therapies are somewhat operator dependent, services must be provided by a physician (M.D., D.O., or D.P.M.) who is skilled in the management of chronic wounds and has appropriate training in the use of human skin equivalents. Ulcers that are not appropriate for grafting (e.g. active infection, systemic impairment of healing) are not covered. Adequate perfusion to support the graft must be documented, typically by the presence of pedal pulses and/or an Ankle Brachial Index of 0.7 or greater.



Keratinocytes (epidermis cellular component) from neonates are preferentially used as the source of expanded cultured allografts. They are better responders to mitogens than older donors and they release factors that stimulate growth of other keratinocytes, a property that is substantially lost by adult keratinocytes. Included among these mediators are epidermal-derived thymocyte activating factor, interleukins, fibronectin, and transforming growth factor-beta.

Fibroblasts (dermis cellular component) and collagen-matrix proteins (dermis extracellular component), influence epithelial migration and differentiation, dermoepidermal junction formation, wound contraction, and scar formation. Dermal cells also secrete growth factors and cytokines, which modulate cell proliferation and differentiation. Collagen synthesis by fibroblasts forms a scaffold for cellular migration.

Skin replacements can be temporary or permanent; they can consist of only epidermal cell components, only dermal components, or a bilayer containing dermal and epidermal elements; they can also be synthetic, biosynthetic or biologic.

Current biologic skin substitutes present benefits that include a non-invasive painless grafting procedure, no requirement for anesthesia, and outpatient (office/treatment room) performance.

Apligraf (Graftskin)



Apligraf is a biosynthetic, bi-layered living construct of cultured human neonatal foreskin which consists of keratinocytes and fibroblasts. It is a human skin equivalent with appearance similar to human skin that was approved by the FDA in May 1998 for use in the treatment of venous skin ulcers, and later approved for the treatment of neuropathic diabetic ulcers in June 2000. It contains both dermal and epidermal components, each housing living cells. This bioengineered product is composed of a bovine-collagen, fibroblast-containing matrix integrated with a sheet of stratified human epithelium. Fibroblasts taken from human neonatal foreskin are cast in a bovine-collagen lattice, which then is seeded with epidermal cells to produce a bilayered skin equivalent. Apligraf is metabolically, morphologically, and biochemically similar to human skin.

The skin equivalent produces a number of cytokines and growth factors and is immunologically well tolerated. There is no evidence of host antibody or cell-mediated response or clinical rejection because there are no macrophages, lymphocytes, or Langerhans' cells present in this skin substitute. Apligraf has been shown to stimulate wound fibroblasts and to counteract growth inhibitory activity present in chronic wound fluid.

Apligraf should be applied to a clean debrided ulcer and must be used in conjunction with the recommended post-application compression therapy and/or pressure off-loading.

Dermagraft



Dermagraft is a biosynthetic, dermal substitute approved by FDA in September 2001 for use in the wound closure of diabetic foot ulcers. It consists of cultured neonatal fibroblasts, produced by taking dermal fibroblasts from neonatal foreskin and seeding them onto a three-dimensional scaffold consisting of a bioabsorbable material (polyglactin mesh). The cells grow and divide, producing collagens, extracellular matrix proteins, and growth factors found in normal, healthy human dermis. Dermagraft is cryopreserved to 70degrees centigrade and thawed before patient application. This skin substitute stimulates the formation of granulation tissue, re-epithelialization, and angiogenesis. The fibroblasts produce collagens, fibronectin and glycosaminoglycans. They also produce transforming growth factor Beta, which stimulates collagen formation. Fibroblasts produce keratinocyte growth factor and secrete vascular endothelial growth factor and hepatocyte growth factor.

Dermagraft was developed for skin replacement of full-thickness wounds. It has no Silastic membrane, an outer silicone polymer layer that serves as an epidermis. Mesh absorption occurs in 60-90 days.

Other HSE



Any other new comparable HSEs will be similarly covered by this article, with coverage restricted to the FDA indications of the product. New products will be added to the article as administrative updates. OrCel, Transcyte and Dermagraft TC are included to this LCD coverage.


Indications:

1. Treatment of neuropathic diabetic foot ulcers with all the following criteria:

 

  • Non-infected full thickness ulcers;
  • Ulcers that extend through the dermis but do not involve the tendon, muscle, joint capsule or have bone exposure;
  • Ulcers that are located on the plantar, medial, or lateral surface of the foot, including the heel;
  • Ulcers free of infection, tunnels, tracts, cellulitis, eschar, or obvious necrotic material, as this will interfere with device adherence and wound healing;
  • Ulcers of greater than six weeks duration;
  • Ulcers that have not adequately responded to conventional ulcer therapy of at least 4 weeks duration;
  • Patients with documented type 1 or type 2 diabetes who are currently receiving medical management for this condition;
  • Extremity that is free of active Charcot's Arthropathy.



2. Treatment of venous insufficiency ulcers with all the following criteria: (Apligraf only)

 

  • Non-infected partial or full-thickness skin ulcers;
  • Ulcers which are not responding to intensive conventional ulcer therapy of at least one month duration;
  • Ulcers greater than 1 month duration (since conservative therapy must have been tried for at least one month)
  • HSE Use in conjunction with standard therapeutic compression techniques;



A course of intensive conventional ulcer therapy is intended to signify:

 

  • At least 4 serial physician evaluations (or a combination of physician and nurse practitioner/physician assistant evaluations clearly under the overall direction of the physician);
  • Active debridement of necrotic tissue to promote healing (including either wet to dry dressing, water debridement, enzymatic debridement or selective surgical curettage) or documentation that no necrotic tissue is present;
  • Maintenance of dressings in accordance with any of the commonly accepted current wound care practices;
  • Prevention and/or eradication of secondary infection
  • Non-weight bearing status
  • Compressive dressings
  • Routine supportive care such as nutritional support and edema control.



Limitations of Coverage:

The frequency of the device application for both venous insufficiency ulcers and neuropathic diabetic foot ulcers should be consistent with patient's history and response to the device application. Repeated application without signs of improvement or exceeding the recommended frequency, per labeling instructions, will be denied.

1. Neuropathic Diabetic Foot Ulcers

 

  • Use of the skin substitute is indicated for up to three separate applications to any given ulcer (Apligraf, OrCel, Transcyte) or eight applications (Dermagraft, Dermagraft TC);
  • There should be no fewer than three weeks between applications (Apligraf, OrCel, Transcyte), whereas Dermagraft/Dermagraft TC should be applied weekly; and,
  • If, after nine to twelve weeks of treatment and three applications of Apligraf, OrCel or Transcyte; or eight applications of Dermagraft or Dermagraft TC, satisfactory healing progress is not noted, reapplication of the skin substitute is not recommended and other treatment modalities should be considered.
  • Re-treatment of the same site/ulcer within one year is not covered.



2. Venous Stasis Ulcers

Two applications of the skin substitute are indicated. If after 12 weeks of compression treatment and two applications of the skin substitute, a 50 percent or greater improvement is noted and documented, then re-application of a third skin substitute will be covered. Otherwise, reapplication of the skin substitute is not recommended and other treatment modalities should be considered:

 

  • There should be no fewer than six weeks between applications; and,
  • Re-treatment of the same site/ulcer within one year is not



3. Contraindications for all ulcers

Any of the following contraindications would preclude treatment of both venous stasis ulcers and neuropathic diabetic foot ulcers with skin substitutes:

 

  • ulcer showing clinical signs of active infection (i.e., increased exudate, odor, redness, swelling, heat, pain, tenderness to the touch, purulent discharge);
  • osteomyelitis;
  • allergy to bovine collagen or hypersensitivity to any of the components;
  • inadequately treated diabetes ("adequately treated" diabetes for purposes of this LCD would be based on documentation in the medical record);
  • uncontrolled rheumatoid arthritis and/or rheumatoid ulcers;
  • other uncontrolled collagen vascular disease;
  • patients who have undergone radiation and/or chemotherapy within the month immediately preceding the skin substitute treatment.



4. Requirement for adequate perfusion

Significant arterial insufficiency is an additional contraindication to the placement of skin substitutes. An Ankle Brachial Index (ABI) of less than 0.7 or absent pedal pulses indicates the presence of significant arterial insufficiency. If skin substitutes are used when such findings are present, the medical record must contain additional test results or information that establishes the presence of sufficient arterial blood supply to allow the wound to heal in the presence of skin substitutes.

5. Additional applications

The use of more than three applications of Apligraf, OrCel or Transcyte; or eight of Dermagraft or Dermagraft TC is rarely medically necessary. Any applications beyond the norm will require extensive documentation of a clear and unique justification for the additional procedure as this is exceeding the usual norms of medical care.

6. Requirement for practitioner expertise

The application of all human skin equivalents is limited to physicians (M.D., D.O. and D.P.M.) who are highly skilled in wound care management and have experience in the use of HSE. The success of the procedure is somewhat dependent on the skill of the performing provider; therefore, the provider may be subject to a post payment peer review in order to verify his/her qualifications.


 

 

Coverage Topic 

Surgical Dressings
Surgical Services
 

 

Coding Information

Bill Type Codes: 

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

12x

Hospital-inpatient or home health visits (Part B only)

13x

Hospital-outpatient (HHA-A also) (under OPPS 13X must be used for ASC claims submitted for OPPS payment -- eff. 7/00)

18x

Hospital-swing beds

21x

SNF-inpatient, Part A

22x

SNF-inpatient or home health visits (Part B only)

85x

Special facility or ASC surgery-rural primary care hospital (eff 10/94)

 

 

Revenue Codes: 

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

 

036X

Operating room services-general classification

045X

Emergency room-general classification

051X

Clinic-general classification

0636

Drugs requiring specific identification-detailed coding (eff 3/92)

076X

Treatment or observation room-general classification

 

 

CPT/HCPCS Codes 

 

J7340

DERMAL AND EPIDERMAL, (SUBSTITUTE) TISSUE OF HUMAN ORIGIN, WITH OR WITHOUT BIOENGINEERED OR PROCESSED ELEMENTS, WITH METABOLICALLY ACTIVE ELEMENTS, PER SQUARE CENTIMETER

J7342

DERMAL (SUBSTITUTE) TISSUE OF HUMAN ORIGIN, WITH OR WITHOUT OTHER BIOENGINEERED OR PROCESSED ELEMENTS, WITH METABOLICALLY ACTIVE ELEMENTS, PER SQUARE CENTIMETER

If the above J-codes are denied, the following application procedure codes will similarly be non-covered.

15340

TISSUE CULTURED ALLOGENEIC SKIN SUBSTITUTE; FIRST 25 SQ CM OR LESS

15341

TISSUE CULTURED ALLOGENEIC SKIN SUBSTITUTE; EACH ADDITIONAL 25 SQ CM

15360

TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS AND CHILDREN

15361

TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND CHILDREN, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

15365

TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS AND CHILDREN

15366

TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND CHILDREN, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

 

 

ICD-9 Codes that Support Medical Necessity 

Neuropathic Diabetes Foot Ulcer (Dermagraft and Apligraf)

250.60

DIABETES WITH NEUROLOGICAL MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED

250.61

DIABETES WITH NEUROLOGICAL MANIFESTATIONS, TYPE I [JUVENILE TYPE], NOT STATED AS UNCONTROLLED

250.80

DIABETES WITH OTHER SPECIFIED MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED

250.81

DIABETES WITH OTHER SPECIFIED MANIFESTATIONS, TYPE I [JUVENILE TYPE], NOT STATED AS UNCONTROLLED

707.14

ULCER OF HEEL AND MIDFOOT

707.15

ULCER OF OTHER PART OF FOOT

Venous Stasis Ulcer (Apligraf only)

454.0

VARICOSE VEINS OF LOWER EXTREMITIES WITH ULCER

459.81

VENOUS (PERIPHERAL) INSUFFICIENCY UNSPECIFIED

707.10

UNSPECIFIED ULCER OF LOWER LIMB

707.11

ULCER OF THIGH

707.12

ULCER OF CALF

707.13

ULCER OF ANKLE

707.14*

ULCER OF HEEL AND MIDFOOT

707.15*

ULCER OF OTHER PART OF FOOT

707.19

ULCER OF OTHER PART OF LOWER LIMB

* 707.14 and 707.15 are only covered for lateral, medial and plantar surfaces.

FOOTNOTE: Claims MUST contain both a 707 localizing code AND a 250/454/459 etiologic code.

 

 

Diagnoses that Support Medical Necessity 

 

 

ICD-9 Codes that DO NOT Support Medical Necessity 

 

 

 

 

ICD-9 Codes that DO NOT Support Medical Necessity Asterisk Explanation 

 

 

Diagnoses that DO NOT Support Medical Necessity 

 

 

General Information

Documentation Requirements 

1. Documentation supporting the medical necessity.

2. Documentation supporting that the ulcer has been treated with intensive conventional non-surgical therapy for a minimum of 4 to 6 weeks and has not decreased in size and/or depth, and the ulcer has not shown any indication (e.g., granulation or progression towards closure) that improvement is likely;

3. Documentation indicating the initial size of the ulcer(s), the size following cessation of conservative management, the size at the beginning of skin substitute treatment, and periodically during treatment with skin substitutes;

4. If more than three (Apligraf, OrCel, Transcyte) or eight (Dermagraft, Dermagraft TC) separate applications of skin substitute are provided to the same site/ulcer, documentation in the medical record must clearly justify the additional applications, and this documentation must be submitted with the claim to Medicare.

5. In addition, the record must document that wound treatment:

 

  • is accompanied by appropriate wound dressing during the healing period;
  • is accompanied by appropriate compressive dressings during follow-up;



6. Documentation must indicate that appropriate steps were taken to off-load pressure during such treatment;

7. Treatment of the underlying disease must be provided and clearly documented in conjunction with skin substitute treatment.

If the claim is selected for medical review, records provided must address the preceding points and should include:


1. History and Physical

2. M.D. orders/progress notes for services rendered

3. Prior treatment therapies

4. Pertinent tests or procedures

5. Itemization of charges

 

 

Appendices 

>
 

 

Utilization Guidelines 

1. Treatment for venous stasis ulcers with skin substitute normally lasts approximately 12 weeks. If after 12 weeks of compression treatment and two applications of the skin substitute, satisfactory healing progress is not noted, re-application of the skin substitute is not recommended and other treatment modalities should be considered;

2. For neuropathic diabetic foot ulcers, treatment with skin substitute normally lasts approximately 12 weeks. If after nine weeks of treatment and three applications of the skin substitute, satisfactory healing progress is not noted, re-application of the skin substitute is not recommended and other treatment modalities should be considered; and,

3. No re-treatment of the same site/ulcer would be expected within the first year following successful initial treatment. 

 

Sources of Information and Basis for Decision 

Human Skin Equivalents. HGSAdministrators Carrier Policy.

Apligraf. Florida Medicare Intermediary Policy

Bilaminate Skin Substitute (Apligraf). AdminaStar Federal Intermediary Policy

Bilaminate Skin Substitutes. TrailBlazer Health Enterprises Intermediary Policy

Pennoyer, Jennifer W. MD, Susser, Wendy S. MD, Chapman, M. Shane MD. "Ulcers associated with Polyarteritis Nodosa Treated with Bioengineered Human Skin Equivalent (Apligraf)". Journal of the American Academy of Dermatology. Vol 46, No. 1, January 2002.

Bello, Ysabel M.MD, Falabella, Anna F. MD. "Current Therapy - Use of Skin Substitutes in Dermatology". Dermatologic Clinics. Vol 19, No.3, July 2001.

Valencia, Isabel C. MD, Falabella, Anna F. MD, Eaglestein, William H. MD. "Inpatient Dermatology - Skin Grafting". Dermatologic Clinic. Vol 18, No.3, July 2000.

Deery, H.Gunner MD, Sangeorzan, Jon A.MD. "Saving the Diabetic Foot with Special Reference to the Patient with Chronic Renal Failure". Infectious Disease Clinics of North America. Vol 15, No.3, September 2001.

"Diabetic Foot Ulcers". Advanced Tissue Sciences, Inc. Smith and Nephew 2001.

Novartis Pharmaceuticals Corporation. "Apligraf, Supplied as a Living Bilayered Skin Substitute". C.1999-2001

Physician's Desk Reference (PDR) 56 Edition 2002.

"Circumcision Yielding Skin for Ulcerous Feet" www.cirp. org/news/1996.

"Dermagraft". Medical Device Approvals. www.fda.gov/cdrh.

CMS Medicare Learning Network. "Pass-Through Devices Frequently Asked Questions" 09/12/00.

Gentzkow, Gary D MD. "Use of Dermagraft, a cultured Human Dermis, to Treat Diabetic Foot Ulcers". Diabetes Care, Vol. 19, No.4, April 1996.

Naughton, Gail; Mansbridge, Jonathan; Gentzkow, Gary. "A Metabolically Active Human Dermal Replacement for the Treatment of Diabetic Foot Ulcers." Artificial Organs. Vol.21, No.11, 1997.

Gentzkow, Gary; Jensen, Jeffrey; Pollak, Richard. "Improved Healing of Diabetic Foot Ulcers After Grafting with a Living Human Dermal Replacement". Wounds. Vol .11, No. 3, June 1999.

Falanga, V. Sabolinski, M. "A Bilayered Living Skin Construct (Apligraf) Accelerates Complete Closure of Hard to Heal Venous Ulcers. Wound Repair and Regeneration, 7, 201-207. 

 

Advisory Committee Meeting Notes 

Public Open Meeting to discuss the draft policy was held 07/09/2002.

This policy does not reflect the sole opinion of the contractor or contractor medical director. Although the final decision rests with the contractor, this policy was developed in cooperation with advisory groups, which includes representatives from general medicine as well as provider (facility) representatives. 

 

Start Date of Comment Period 

06/05/2002 

 

End Date of Comment Period 

07/20/2002 

 

Start Date of Notice Period 

08/13/2002 

 

Revision History Number 

L1944b 

 

Revision History Explanation 

01/29/2005 - The description for CPT/HCPCS code C1305 was changed in group 1
01/29/2005 - The description for CPT/HCPCS code C9201 was changed in group 1

01/29/2005 - CPT/HCPCS code Q0184 was deleted from group 1

11/26/2005 - The description for CPT/HCPCS code J7340 was changed in group 1

11/26/2005 - CPT/HCPCS code 15342 was deleted from group 1
11/26/2005 - CPT/HCPCS code 15343 was deleted from group 1
11/26/2005 - CPT/HCPCS code C1305 was deleted from group 1
11/26/2005 - CPT/HCPCS code C9201 was deleted from group 1

12/16/2005 - CPT/HCPCS code 7342 was added to group 1

This LCD was converted from an LMRP on 12/8/2005

10/30/2007 - Frequently Asked Questions restored to Appendices

01/25/2008 - New products added OrCel, Transcyte and Dermagraft TC
01/28/2008 - Addition of HCPCS codes for application of products
01/28/2008 - Typographical corrections made

2/18/2008 - The description for Bill code 21 was changed

04/03/2008 - Frequently Asked Questions removed from Appendices as link could not be restored 

 

Reason for Change 

Other
 

Last Reviewed On Date 

04/03/2008 

 

Related Documents 

Article(s)
A37945 - Human Skin Equivalent (HSE)

 

LCD Attachments 

FAQ (8,594 bytes)

 

Other Versions 

Updated on 02/18/2008 with effective dates 01/25/2008 - N/A

Updated on 01/25/2008 with effective dates 01/25/2008 - N/A

Updated on 10/30/2007 with effective dates 12/09/2005 - 01/24/2008

Updated on 09/01/2006 with effective dates 12/09/2005 - N/A

Updated on 12/16/2005 with effective dates 12/09/2005 - N/A

Updated on 12/08/2005 with effective dates 01/29/2005 - 12/08/2005

Updated on 01/29/2005 with effective dates 12/18/2002 - 01/28/2005

Updated on 09/08/2004 with effective dates 12/18/2002 - N/A

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Updated on 10/21/2002 with effective dates 09/29/2002 - N/A

Updated on 10/04/2002 with effective dates 09/29/2002 - N/A