See link & the pasted info from Trailblazer Health LCD on Dermagraft:
Medicare provides payment for the amount of the bioengineered skin substitute product that is reasonable and necessary to treat the patientâ€™s wound. If the physician has made good faith efforts to minimize the unused portion of the bioengineered skin substitute product in how patients are scheduled and how he ordered, accepted, stored and used the product and made good faith efforts to minimize the unused portion of the product in how it is supplied, the program will cover the amount of product discarded along with the amount used to treat the wound. Documentation requirements for unused/discarded materials are given below. Discarded materials must be reported separately from the medically necessary material used to treat a wound. Coding and billing instructions for discarded materials are referenced in the attached article. Coding and billing instructions can be referenced in the attached article. Refer to national policy: Medicare Claims Processing Manual â€“ Pub. 100-04, Chapter 17, Section 40.
Medicare will monitor and evaluate claim data related to discarded materials. Seeking additional payment from Medicare (by reporting on a separate claim materials previously reported as discarded) for wasted/discarded material constitutes a false claim â€“ a felony crime punishable under federal law.[/I][/I][/I]
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