Coding, coverage, and reimbursement information provided does not constitute legal advice and does not guarantee payment. It is always the provider’s responsibility to determine and submit appropriate codes and charges for services rendered.
Reimbursement for surgical techniques is highly important to healthcare providers and patients. Selecting the most appropriate code(s) for each procedure can be influenced by many variables and should be evaluated based on the patient-specific circumstance for each case and the site of service.
To ensure your patient meets his/her carrier’s medical necessity policy criteria, or to find out if a pre-authorization or pre-determination is required, it is recommended that you contact the patient’s payer directly.
Also, visit the links below for other reimbursement resources regarding Prokera®, AmnioGraft®, and AmnioGuard® provided by our reimbursement consulting partners.