Update: As of this morning (02/01/12) CMS has added 15275 to Noridian LCD L23684 and updated the coverage requirement for skin substitute grafting. I read it to mean 15275 can't be used with MOHS and is not seperatly payable. Here is a blurb from the referenced LCD:
7. Coverage will not be provided under this LCD for any wound treatment that does not meet the definition of Q4101, Q4102, or Q4106. All other such products, unless they are specifically FDA-labeled as "skin substitutes" and for use in the types of ulcers considered in this LCD, will be denied coverage under this LCD. All such products will be considered to be, at most, "biologic wound dressings." Dressings, by definition, are part of the relevant Evaluation & Management (E/M) service provided and not separately payable. Examples of products considered to fall under this distinction are: Q4100, Q4103, Q4104, Q4105, Q4107, Q4108, Q4110, Q4111, Q4112, Q4113, Q4114, Q4115, Q4116, Q4117, Q4118, Q4119, Q4120, Q4121, Q4122, Q4123, Q4124, Q4125, Q4126, Q4127, Q4128, Q4129, and Q4130.
As examples of such non-covered "wound dressing" products Biovanceâ„¢ (Biovanceâ„¢ is described in its FDA-labeling as "wound covering") and Integraâ„¢ are considered wound dressings, not skin substitutes, and are not separately payable by Medicare. Use of these products is included within the appropriate level of E/M service, and to code as "skin substitutes" would be inappropriate coding.
If and as literature in support of the use of the non-covered products noted in this LCD becomes available, and as that literature concerning their use sufficiently matures, NAS will welcome requests for reconsideration of this coverage decision. However, these requests for reconsideration must be submitted as formal reconsideration requests (See www.noridianmedicare.com for the reconsideration process.) and must be accompanied by complete copies of relevant peer-reviewed literature that support the recommendation as well as complete copies of FDA labeling for their uses (providers are reminded that abstracts are not acceptable - by Medicare rule - for this purpose).
(Providers are again reminded that the application of the dressings noted above is not separately paid, such as if billed with CPT codes 15271-15278).
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