Reimbursement and Coding Guide
Reimbursement and eligibility for coverage for the use of these products and associated procedures varies by Medicare and payers. Coverage policies, prior authorizations, contract terms, billing edits, and site of service influence reimbursement. It is recommended that providers verify coverage and billing policies.
Indications for Use
Excellagen is indicated for the management of wounds including: partial and full-thickness wounds, pressure ulcers, venous ulcers, diabetic ulcers, chronic vascular ulcers, tunneled/undermined wounds, surgical wounds (donor sites/graft, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence), trauma wounds (abrasions, lacerations, second-degree burns and skin tears) and draining wounds.
Coding for Low Cost Skin Substitute Graft Procedures
For 2018, report HCPCS procedure codes C5271-C5278 when Medicare patients are treated with skin graft procedures in the out-patient facility. Please verify with your payer prior to submission of these codes. Excellagen has yet to be classified as a high, or low-cost skin substitute.