Wiki 707.13: Ulcer of ankle

jsweeney23

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I have a question regarding the indications of a skin substitute (Dermagraft) and if 707.13 is appropriate to use. Per its FDA indications, Dermagraft is to be used for diabetic foot ulcers (DFUs).

Since 707.13 (ulcer of ankle) is listed in most Medicare LCDs as covered when billed with Dermagraft (HCPCS Q4106) and its application (CPT 15365), would the ankle then be considered part of the foot? Or, would 707.13 truly be an off-label diagnosis that so happens to be covered by many Medicare carriers?

Thanks in advance for any input!

-Jen
 
My experience with commercial insurance will only pay for 707.13 and 707.14 if they don't deny it as experimental.
 
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