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American Medical Association (AMA)

CPT Changes 2007

The Skin Replacement Surgery and Skin Substitute introductory-language has been editorially revised by removing the phrase "without surgical fixation of the skin substitute/graft" from the last paragraph. The language continues to indicate that fixation is required. The word surgical has been removed from the text. However, because some types of skin substitutes or grafts do not require surgical fixation, the revised language gives the surgeon the ability to choose the most appropriate type of fixation.1

For Questions regarding reimbursement related to Apligraf® please call the Reimbursement Support Center (1-888-Heal-2-DAY), Option 3.

Click the state on the map to find state specific coding and coverage guidelines where it is available. Select Medicare LCD Summary Part A or Medicare LCD Summary Part B.

• For facilities billing Wisconsin Physician Services, Formerly Mutual of Omaha click here

Alabama

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

Alaska

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

Arizona

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

Arkansas

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Pinnacle Policy		Pinnacle Policy

 

 

California

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

Colorado

 

Part A LCD for Apligraf		Part B LCD for Apligraf
TrailBlazer Policy		TrailBlazer Policy

 

 

Connecticut

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		National Gov Services Policy

 

 

Delaware

 

Part A LCD for Apligraf		Part B LCD for Apligraf
HighMark Policy		HighMark Policy

 

 

District of Columbia

 

Part A LCD for Apligraf		Part B LCD for Apligraf
HighMark Policy		HighMark Policy

 

 

Florida

 

Part A LCD for Apligraf		Part B LCD for Apligraf
First Coast Policy		First Coast Policy

 

 

Georgia

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

Hawaii

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

Idaho

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Cigna Policy

 

 

Illinois

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		Wisconsin Physician Policy

 

 

Indiana

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		National Gov Services Policy

 

 

Iowa

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Wisconsin Physician Policy		Wisconsin Physician Policy

 

 

Kansas

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Wisconsin Physician Policy		Wisconsin Physician Policy

 

 

Kentucky

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		National Gov Services Policy

 

 

Louisiana

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		Pinnacle Policy

 

 

Maine

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Heritage Policy		National Heritage Policy

 

 

Maryland

 

Part A LCD for Apligraf		Part B LCD for Apligraf
HighMark Policy		HighMark Policy

 

 

Massachusetts

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Heritage Policy		National Heritage Policy

 

 

Michigan

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		Wisconsin Physician Policy

 

 

Minnesota

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Wisconsin Physician Policy

 

 

Mississippi

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

Missouri

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Wisconsin Physician Policy		Wisconsin Physician Policy

 

 

Montana

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

Nebraska

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Wisconsin Physician Policy		Wisconsin Physician Policy

 

 

Nevada

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

New Hampshire

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Heritage Policy		National Heritage Policy

 

 

New Jersey

 

Part A LCD for Apligraf		Part B LCD for Apligraf
HighMark Policy		HighMark Policy

 

 

New Mexico

 

Part A LCD for Apligraf		Part B LCD for Apligraf
TrailBlazer Policy		TrailBlazer Policy

 

 

New York

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		National Gov Services Policy

 

 

North Carolina

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		Cigna Policy

 

 

North Dakota

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

Ohio

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		No Formal Policy

 

 

Oklahoma

 

Part A LCD for Apligraf		Part B LCD for Apligraf
TrailBlazer Policy		TrailBlazer Policy

 

 

Oregon

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

Pennsylvania

 

Part A LCD for Apligraf		Part B LCD for Apligraf
HighMark Policy		HighMark Policy

 

 

Puerto Rico

 

Part A LCD for Apligraf		Part B LCD for Apligraf
First Coast Policy		First Coast Policy

 

 

Rhode Island

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Heritage Policy		National Heritage Policy

 

 

South Carolina

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

South Dakota

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

Tennessee

 

Part A LCD for Apligraf		Part B LCD for Apligraf
No Formal Policy		No Formal Policy

 

 

Texas

 

Part A LCD for Apligraf		Part B LCD for Apligraf
TrailBlazer Policy		TrailBlazer Policy

 

 

Utah

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

Vermont

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Heritage Policy		National Heritage Policy

 

 

Virginia

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		TrailBlazer Policy

 

 

Virgin Islands

 

Part A LCD for Apligraf		Part B LCD for Apligraf
First Coast Policy		First Coast Policy

 

 

Washington

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

 

West Virginia

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		No Formal Policy

 

 

Wisconsin

 

Part A LCD for Apligraf		Part B LCD for Apligraf
National Gov Services Policy		Wisconsin Physician Policy

 

 

Wyoming

 

Part A LCD for Apligraf		Part B LCD for Apligraf
Noridian Policy		Noridian Policy

 

1American Medical Association, CPT Changes 2007-An Insider’s View, pg. 27

Disclaimer: The information provided on this website is informational only. This is not a guarantee of Reimbursement Rates, nor is it intended to make recommendations regarding clinical practices. Information on this website is subject to change with out notice due to changes in reimbursement laws, regulations, rules and policies. The ultimate responsibility for correct coding lies with the provider of services. Please contact the appropriate payer for their interpretation of the appropriate code to use for the procedure.

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Apligraf® is a registered trademark of Novartis