Last updated on 1/17/24 | First published on 11/16/17 | Literature review current through Oct. 2024
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Unbiased information for educational purposes only. WoundReference does not produce, market, advertise, re-sell or distribute healthcare goods or services consumed by, or used on patients. For information about specific products, please contact the manufacturer directly.
Cytal™ Burn Matrix is an acellular matrix.
INTENDED USES: is intended for the management of wounds including: second-degree burns, partial and full-thickness wounds, pressure ulcers, venous ulcers, diabetic ulcers, chronic vascular ulcers, tunneled/ undermined wounds, surgical wounds (donor sites/grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence), trauma wounds (abrasions, lacerations, skin tears) and draining wounds.
CLAIMED FEATURES: It facilitates the remodeling of functional, site-appropriate tissue. Comprised of ACell’s proprietary MatriStem UBM™ (Urinary Bladder Matrix) technology, these biologically-derived devices maintain an intact epithelial basement membrane which facilitates cellular infiltration and capillary ingrowth. It is intended for one-time use. Cytal Burn Matrix is contraindicated for third-degree burns.
OPTIONS: Per square centimeter
BMM0505: Cytal Burn Matrix, Meshed, 5 x 5 cm, box of 1
BMM0710: Cytal Burn Matrix, Meshed, 7 x 10 cm, box of 1
BMM1015: Cytal Burn Matrix, Meshed, 10 x 15 cm, box of 1
Manufacturer: Integra LifeSciences Corp.
Information retrieved from manufacturer and/or FDA-approved labels
* Wound Reference does not produce, market, re-sell or distribute health care goods or services consumed by, or used on, patients. The product information contained on this page, including the product images and additional product materials, was collected from various supplier sources. All product claims and specifications are those of the product suppliers. Every effort has been made to ensure the accuracy of the product information, however on occasion manufacturers may alter their products or packaging without notice. Wound Reference assumes no liability for inaccuracies or misstatements about products. The properties of a product may change or be inaccurate following the posting or printing of the product information in the document, either in the print or online version. Due to product changes, information listed in this document is subject to change without notice. We recommend that you always read labels, warnings and instructions for use before using a product. Content on this site is for reference purposes and is not intended to be a substitute for professional advice given by a physician or other licensed healthcare professional.
ESSENTIALS
Product
Estimated
Out-of-pocket
Cost
HCPCS Class
HCPCS
Cytal, per square centimeter
Q4166
* Hover on the information button next to each header for detailed explanation on the type of information provided by the table
Select your state for Medicare
DME coverage and co-payment
Product
Estimated
Out-of-pocket
Cost
Patient DME Co-Payment per Billable Unit
DME Reimbursement to Suppliers
Frequency Replacement if Requirements Met
Office and/or Facility - Product reimbursement
$.00
per square centimeter (non-DMEPOS)
See Coding, Coverage and Reimbursement
* Every effort has been made to ensure the accuracy of the product information, however you should visit the manufacturer's website for the latest information.
* Hover on the information button next to each header for detailed explanation on the type of information provided by the table
Product
Estimated
Out-of-pocket
Cost
Recom / Evidence
FDA Safety
Quality Measures
Cost Effectiveness
Product
Estimated
Out-of-pocket
Cost
Composition: Animal-derived
Configuration: Fenestrated/ meshed
Configuration: Sheet
May apply on full-thickness wounds
Processing: Dehydrated
Shelf life: Greater than 2 years
Storage: room temp
| CPT Code | Description |
Physician Reimbursement - Office
|
Physician Reimbursement - Facility
|
Facility Reimbursement
|
| C5271 | Low cost skin substitute app |
|
|
$534.89
|
| C5273 | Low cost skin substitute app |
|
|
$1,749.26
|
| C5274 | Low cost skin substitute app |
|
|
|
| C5275 | Low cost skin substitute app |
|
|
$534.89
|
| C5272 | Low cost skin substitute app |
|
|
|
| C5276 | Low cost skin substitute app |
|
|
|
| C5277 | Low cost skin substitute app |
|
|
$534.89
|
| C5278 | Low cost skin substitute app |
|
|
|
- Based on national averages
- Medicare payments for participating qualified health professionals (QHP) for services performed in their Offices (*) or at a Facility (** i.e., hospital outpatient department or ambulatory service center). Payments are nationally unadjusted average amounts, and do not account for differences in payment due to geographic variation. The allowed rate for non-participating physicians is set at 95% of the allowable for participating physicians. Non-participating physicians are subject to the limiting charge rules. The coinsurance is limited to 20% of the allowable fee.
- When covered by the Medicare contractor, this manufacturer product is separately payable in a QHP office based on the Average Sales Price (ASP) as reported by the manufacturer on a quarterly basis.
- Hover on the information button next to each header for detailed explanation on the type of information provided by the table
- The information provided on this website is informational only. This is not a guarantee of Reimbursement Rates, nor is it intended to make recommendations regarding clinical practices. Information on this website is subject to change with out notice due to changes in reimbursement laws, regulations, rules and policies. The ultimate responsibility for correct coding lies with the provider of services. Please contact the appropriate payer for their interpretation of the appropriate code to use for the procedure.
- CPT® is a registered trademark of the American Medical Association. All CPT codes and descriptions are copyrighted 2018, American Medical Association. All rights reserved. CPT codes and CPT descriptions are from the current manuals and those included herein are not intended to be all-inclusive and are included for informational purposes only. Codes referenced on Wound Reference are for informational purposes only. Inclusion or exclusion of any codes does not guarantee coverage. Providers should reference the American Medical Association prior to the submission of claims for reimbursement of covered services.
* Scroll table to see all products.
CLINICAL
Indications
Cytal Burn Matrix is intended for the management of wounds including: second-degree burns, partial and full-thickness wounds, pressure ulcers, venous ulcers, diabetic ulcers, chronic vascular ulcers, tunneled/undermined wounds, surgical wounds (donor sites/ grafts, post-Mohs surgery, post-laser surgery, podiatric, wound dehiscence), trauma wounds (abrasions, lacerations, skin tears), and draining wounds. The device is intended for one time use.
Contraindications
1. Patients with known sensitivity or allergy to porcine materials.
2. Third-degree burns.
Warnings
1. Exposure to contaminated or infected field can lead to rapid breakdown of device.
2. If active infection is present, treat patient to resolve infection prior to device application.
3. Do not use if cracked, broken, or otherwise damaged.
How supplied
- BMM0505: Cytal Burn Matrix, Meshed, 5 x 5 cm,1/box: Q4166
- BMM0710: Cytal Burn Matrix, Meshed, 7 x 10 cm, 1/box: Q4166
- BMM1015: Cytal Burn Matrix, Meshed, 10 x 15 cm, 1/box: Q4166
CODING, COVERAGE AND REIMBURSEMENT
This section currently focuses primarily on Medicare. It may be expanded in the future to include information on private insurers as well.
Medicare hospital outpatient prospective payment system (OPPS) cost category assignment:
Frequency of replacement allowed by Medicare:
| Medicare Administrative Contractor (MAC) |
Frequency of replacement if requirements met |
| Novitas Solutions, Inc. |
10 units in 12 weeks
|
| CGS Administrators, LLC |
10 units in 12 weeks
|
| First Coast Service Options, Inc. (FCSO) |
1 type of product per 12 weeks, fewest repeat applications and amount of product is expected
|
|
Palmetto
Noridian
Wisconsin Physicians Service Insurance Corporation (WPS)
National Government Services, Inc. (NGS)
|
Carrier discretion
|
More details on requirements, medical necessity and documentation in specific Medicare Local Coverage Determinations (if available). See section on Coding, Coverage and Reimbursement in topic "Cellular and/or Tissue Products".
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NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.
