C5278

Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)

Short Description

Low cost skin substitute app

HCPCS Coverage Code

D = Special coverage instructions apply

HCPCS Action Code

N = No maintenance for this code

HCPCS Action Effective Date

January 01, 2014

HCPCS Code Added Date

January 01, 2014

HCPCS Pricing Indicator Code

53 = Statute

HCPCS Multiple Pricing Indicator Code

A = Not applicable as HCPCS priced under one methodology

HCPCS Statute Number

1833(t)

HCPCS Type Of Service Code

2 = SurgeryF = Ambulatory surgical center (facility usage for surgical services)