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Apligrafts
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9/26/2012 at 3:43:05 PM GMT
Posts: 14
Apligrafts

Does Medicare consider an Apligraft a skin graft (996.52) since it is made from directly human tissue.  ALso has anyone had luck getting this approved through Medicare or other insurance companies?

Thanks



9/27/2012 at 12:20:15 PM GMT
Posts: 16
Our Wound Center uses Apligraf all the time.  It's a synthettic skin graft created from cells found in healthy human skin and collagen from cows.  It is covered by CMS as long as the criteria are met (Diabetic Foot Ulcer & Venous Leg Ulcers).  Try contacting Organogenesis, they can help you with any questions you may have. 888-432-5232.


9/28/2012 at 11:30:28 AM GMT
Posts: 14
I apologize, I was asking if Medicare considered Apligraft a skin graft with regards to using HBOT.  If the graft does not take, is this considered a graft failure since it is derived from human cells. Thanks


10/2/2012 at 3:57:26 PM GMT
I am going to go with a no on that one.  I do not think the ins world is going to count an Apligraf or Dermagraft in the same catagory a normal skin graft.  The aforementioned two txs are more  dermal substitutes or fibroblasts applied in a clinic setting and usually approval for this tx is for multiple attempts for success. The cells from that tissue adhere and sort of migrates across a wound bed.  The latter is human tissue,skin transplant conducted while the pt is typically under general anesthesia.  I don't see that they would be considered the same. If I am wrong, I'd love to hear it.


12/2/2012 at 10:51:38 AM GMT
Posts: 16
not allowable by Medicare.


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