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Medicare Coverage Determinations for Wound Care

Medicare Coverage Determinations for Wound Care

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Medicare Coverage Determinations for Wound Care

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INTRODUCTION

To ensure proper Medicare reimbursement and smooth Medicare audits, clinicians must familiarize themselves with the Coding and Reimbursement guidelines for Wound Care and ensure compliance with the Centers for Medicare and Medicaid Services. This topic provides a map of the Medicare Part A/B Medicare Administrative Contractors Jurisdictions and respective coverage determinations. For Medicare Coverage Determinations for Hyperbaric Oxygen Therapy, see "Medicare Coverage Determinations for Hyperbaric Oxygen Therapy" 


NATIONAL OR LOCAL COVERAGE DETERMINATIONS

The map below shows the Medicare Part A/B Medicare Administrative Contractors (MAC) Jurisdictions. MACs determine which types of interventions are covered along with documentation needed to justify medical necessity, utilization guidelines, frequency allowed, etc. Clinicians who bill Medicare should adhere to the guidance provided by their MAC to ensure proper reimbursement and smooth audits, should they occur. 

Instructions

  1. On the map below, find your state and respective MAC (see abbreviation of the MAC in the white bubbles)
  2. In the table below the map, find your MAC in the left column. In the right column, check if the MAC follows its own Local Coverage Determination (LCD) or if it follows the National Coverage Determination (NCD) 
  3. To go to the NCD or LCD, click on its reference number (in blue brackets in the right column). On the reference page, click on the green button "View Source" to go to the specific LCD or NCD on the CMS website.
  4. See details on requirements, medical necessity and documentation on specific Medicare National and Local Coverage Determinations
  5. For latest updates of each NCD, LCD or local coverage article, scroll to the bottom section 'Revision History Information'    


Medicare Administrative Contractor (MAC)  
Local Coverage Determinations (LCD) and Policy Articles
CGS Administrators, LLC (CGS)
  • L34045   Non-Invasive Vascular Studies, Revision Effective Date 06/12/2025 [1]
  • A56697   Billing and Coding: Non-Invasive Vascular Studies, Revision Effective Date 03/23/2025 [2]
  • L34049 Outpatient Physical and Occupational Therapy Services, Revision Effective Date 05/29/2025 [3]
  • A57067 Billing and Coding: Outpatient Physical and Occupational Therapy Services, Revision Effective Date 05/29/2025 [4]
  • L36690   Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities, Revision Effective Date 09/05/2024 [5]
  • A56696   Billing and Coding: Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities, Revision Effective Date 09/05/2024 [6]
  • A55276   Response to Comments: Wound Application of Cellular and/or Tissue Based products (CTPs), Lower Extremities, Original Effective Date 10/10/2016 [7]
  • L34032  Debridement Services, Revision Effective Date 10/03/2024 [8]
  • A56459    Billing and Coding for Debridement Services, Revision Effective Date 10/03/2024 [9]
  • L33942  Physical Therapy - Home Health, Revision Effective Date 06/27/2024 [10]
  • A57311  Billing and Coding: Physical Therapy - Home Health, Revision Effective Date 06/27/2024 [11]
  • L33830    Pressure Reducing Support Surfaces - Group 1, Revision Effective Date 05/01/2021 [12]
  • A52489  Pressure Reducing Support Surfaces - Group 1 - Policy Article, Revision Effective Date 05/01/2021 [13]
  • L33642  Pressure Reducing Support Surfaces - Group 2, Revision Effective Date 05/01/2021 [14]
  • A52490    Pressure Reducing Support Surfaces - Group 2 - Policy Article, Revision Effective Date 01/01/2020 [15]
  • L33692    Pressure Reducing Support Surfaces - Group 3, Revision Effective Date 05/01/2021 [16]
  • A52468    Local Coverage Article: Pressure Reducing Support Surfaces - Group 3 - Policy Article, Revision Effective Date 01/01/2020 [17]
  • A59219   Response to Comments: Pneumatic Compression Devices - DL33829, Original Effective Date 09/07/2023 [18]
  • L33821 Negative Pressure Wound Therapy Pumps, Revision Effective Date 01/01/2024 [19]
  • A52511 Negative Pressure Wound Therapy Pumps - Policy Article, Revision Effective Date 08/15/2021 [20]
  • L33831   Local Coverage Determination for Surgical Dressings, Revision Effective Date 01/01/2024 [21]
  • A54563 Surgical Dressings - Policy Article, Revision Effective Date 12/05/2024 [22]
  • A56175 Low frequency, non-contact, non-thermal ultrasound (CPT code 97610), Revision Effective Date 02/27/2025 [23]
  • A55426   Standard Documentation Requirements for All Claims Submitted to DME MACs, Revision Effective Date 01/01/2024 [24]
  • L34246   Routine Foot Care and Debridement of Nails, Revision Effective Date 08/08/2024 [74]
  • L39756  Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [25]
  • A59618  Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Revision Effective Date 01/01/2026 [26]
  • A59941 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [27]
First Coast Service Options, Inc. (FCSO)
  • L37166   Wound Care, Revision Effective Date 07/23/2020 [28]
  • A55818 Billing and Coding: Wound Care, Revision Effective Date 01/01/2025 [29]
  • A55757 Wound care (L37166): Medicare Part A/B local coverage determination (LCD) comment summary, Revision Effective Date 12/07/2017 [30]
  • L33667   Duplex Scan Of Lower Extremity Arteries, Revision Effective Date 10/01/2019 [31] 
  • L33693   Non-Invasive Evaluation of Extremity Veins, updated on 01/28/2024, Revision Effective Date 01/28/2024 [32]
  • L33696 Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries [33] - RETIRED
  • A58810   Billing and Coding: Platelet Rich Plasma, updated on 07/01/2023, Revision Effective Date 07/01/2023 [76]
  • L36377 Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities, Revision Ending Date 12/31/2025 [34]
  • A57680 Billing and Coding: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities, Revision Effective Date 08/13/2020 [35]
  • L36377  Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Revision Effective Date 01/01/26 [36]  
  • A57680 Billing and Coding: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Revision Effective Date 01/01/26 [37] 
  • L38720   Local Coverage Determination (LCD) Treatment of Chronic Venous Insufficiency of the Lower Extremities, Original Effective Date 12/27/2020 [38] 
  • L39071   Platelet Rich Plasma, Revision Effective Date 12/12/2021 [77]
  • A59518  Response to Comments: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 08/03/2023 [39]
  • A59824 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [40]
National Government Services, Inc. (NGS)
  • L33563 Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures, Revision Effective Date 09/12/2019 [41]
  • L33614   Debridement Services, Revision Effective Date 11/07/2019 [42]
  • A56617 Billing and Coding: Debridement Services, Revision Effective Date 01/01/2024 [43]
  • L33627   Non-Invasive Vascular Studies, Revision Effective Date 10/01/2019 [44]
  • L33631   Outpatient Physical and Occupational Therapy Services, Revision Effective Date 01/01/2020 [45]
  • A56566 Billing and Coding: Outpatient Physical and Occupational Therapy Services, Revision Effective Date 01/01/2025 [46]
  • A57759 Billing and Coding: Routine Foot Care and Debridement of Nail, Revision Effective Date 08/22/2024 [47]
  • L38937   Platelet Rich Plasma, Revision Effective Date 02/10/2022 [78]
  • L39828 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [48]
  • A59953 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [49]
  • A59712 Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [50]
Noridian
  • A53046 Wound Care and Debridement - Provided by a Therapist, Physician, NPP, or as Incident-to Service, Revision Effective Date 01/01/2024 [51]
  • A53296 Wound Care & Debridement – Provided by a Therapist, Physician, NPP or as Incident-to Services, Revision Effective Date on 01/01/2024 [52]
  • A52959 Billing and Coding: Lymphedema Decongestive Treatment, Revision Effective Date 01/01/2018 [53]
  • A55710 Lymphedema Decongestive Treatment, Revision Effective Date 01/01/2018 [54]
  • A52918 Coverage of Foot Care Services, Revision Effective Date 10/01/2015 [55]
  • L33821 Negative Pressure Wound Therapy Pumps, Revision Effective Date 01/01/2024 [ [19]
  • A52511 Negative Pressure Wound Therapy Pumps - Policy Article, Revision Effective Date 08/15/2021 [20]
  • L33830   Pressure Reducing Support Surfaces - Group 1, Revision Effective Date 05/01/2021 [12]
  • A52489 Pressure Reducing Support Surfaces - Group 1 - Policy Article, Revision Effective Date 05/01/2021 [13]
  • L33642 Pressure Reducing Support Surfaces - Group 2, Revision Effective Date 05/01/2021 [14]
  • A52490   Pressure Reducing Support Surfaces - Group 2 - Policy Article, Revision Effective Date 01/01/2020 [15]
  • L33692   Pressure Reducing Support Surfaces - Group 3, Revision Effective Date 05/01/2021 [16]
  • A52468   Pressure Reducing Support Surfaces - Group 3 - Policy Article, Revision Effective Date 01/01/2020 [17]
  • L33831   Local Coverage Determination for Surgical Dressings, Revision Effective Date 01/01/2024 [21]
  • A59219   Response to Comments: Pneumatic Compression Devices - DL33829, Original Effective Date 09/07/2023 [18]
  • A54710   Response to Comments: Treatment of Varicose Veins of Lower Extremities, Original Effective Date 03/12/2016 [56]   
  • A54713   Response to Comments: Treatment of Varicose Veins of Lower Extremities, Original Effective Date 03/12/2016 [57]
  • A54714   Response to Comments: Treatment of Varicose Veins of Lower Extremities, Original Effective Date 03/12/2016 [58] 
  • A54715   Response to Comments: Treatment of Varicose Veins of Lower Extremities, Original Effective Date 03/12/2016 [59]
  • A54563 Surgical Dressings - Policy Article, Revision Effective Date 12/05/2024  [22]
  • A58565   Billing and Coding: Wound and Ulcer Care, Revision Effective Date 01/01/2025 [79]
  • A58567   Billing and Coding: Wound and Ulcer Care, Revision Effective Date 01/01/2025  [80]
  • A58903   Response to Comments: Wound and Ulcer Care, Original Effective Date 11/28/2021 [81]
  • A58904   Response to Comments: Wound and Ulcer Care, Original Effective Date 11/28/2021 [82]
  • L38902   Wound and Ulcer Care, Revision Effective Date 11/28/2021 [83]
  • L38904   Wound and Ulcer Care, Revision Effective Date 11/28/2021 [84]
  • A57957   Billing and Coding: Routine Foot Care, Revision Effective Date 01/01/2024 [88]
  • L35163   Plastic Surgery, Revision Effective Date 02/14/2025 [89]
  • A55932  Billing and Coding: JW and JZ Modifier Billing Guidelines, Revision Effective Date 03/21/2024 [60]
  • A53024  Billing and Coding: JW and JZ Modifier Billing Guidelines, Revision Effective Date 03/21/2024 [61]
  • L39764 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [62]
  • L39760 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [63]
  • A59626 Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [64]
  • A59628 Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [65]
  • A59952 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [66]
  • A59950 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [67]
Novitas Solutions, Inc.
  • L35125   Wound Care, Revision Effective Date 07/23/2020 [68]
  • A53001 Billing and Coding: Wound Care, Revision Effective Date 01/01/2025 [69]
  • L35041  Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds, Revision Effective Date 09/26/2019 [70] 
  • A54117 Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds, Revision Effective Date 08/13/2020 [71]
  • L35041  Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, future effective on 01/01/26 need new reference linking to future effective [72] 
  • A54117  Billing and Coding: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Revision Effective Date 01/01/26 [73]
  • A59517   Response to Comments: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 08/03/2023.[74]
  • A59823 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [75]
  • A58808   Billing and Coding: Platelet Rich Plasma, Revision Effective Date 07/01/2023 [90]
  • L39068   Platelet Rich Plasma, Revision Effective Date 12/12/2021 [92]
  • L34924   Local Coverage Determination (LCD) Treatment of Chronic Venous Insufficiency of the Lower Extremities, Revision Effective Date 12/27/2020 [76] 
  • L34938   Removal of Benign Skin Lesions, Revision Effective Date 09/26/2019 [93]
  • L34887   Surgical Treatment of Nails, Revision Effective Date 01/30/2022 [94]
Palmetto
  • L34428 Outpatient Physical Therapy, Revision Effective Date 05/18/2023 [77]
  • L34427 Outpatient Occupational Therapy, Revision Effective Date 04/13/2023 [78]
  • A53057 Billing and Coding: Home Health Occupational Therapy, Revision Effective Date 1/1/2025 [79] 
  • A56731  Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy, Revision Effective Date 01/01/2024 [80] 
  • A53065  Billing and Coding: Outpatient Physical Therapy, Revision Effective Date 01/01/2025 [81]
  • A53781  Billing and Coding: Spiracur SNaP® Wound Care System, Revision Effective Date 01/01/2024 [82]
  • A54555 Billing and Coding: Low frequency, non-contact, non-thermal ultrasound (CPT code 97610), Revision Effective Date 01/01/2024 [83] 
  • A53064   Billing and Coding: Outpatient Occupational Therapy, Revision Effective Date 1/1/2025 [84]
  • A53773 Low frequency, non-contact, non-thermal ultrasound (CPT code 97610), Revision Effective Date 01/01/2024 [85]
  • A53058   Billing and Coding: Home Health Physical Therapy, Revision Effective Date 01/01/2025 [95]
  • L34560   Home Health Occupational Therapy, Revision Effective Date 06/09/2022 [96]
  • A56392   Response to Comments: Topical Oxygen Therapy, Original Effective Date 03/21/2019 [98]
  • L37873   Topical Oxygen Therapy, Revision Effective Date 05/04/2023 [99]
  • L39121   Local Coverage Determination (LCD): Treatment of Varicose Veins of the Lower Extremities, Revision Effective Date 11/16/2023 [86]
  • A59001  Response to Comments: Treatment of Varicose Veins of the Lower Extremities, Original Effective Date 02/17/2022 [87] 
  • A59281  Response to Comments: Near-Infrared Spectroscopy in Wound and Flap Management, Original Effective Date12/29/2022 [88]
  • A59945 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [89]
  • L39806 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [90]
  • A59691 Billing and Coding: Skin Substitutes Grafts/Cellular Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Original Effective Date 01/01/2026 [91]
Wisconsin Physicians Service Insurance Corporation (WPS)
  • L37228   Wound Care, Revision Effective Date 03/27/2025 [92]
  • A55910  Response to Comments: Wound Care (DL37228), Original Effective Date 04/16/2018 [93]
  • A55909  Billing and Coding: Wound Care, Revision Effective Date 06/26/2025 [94]
  • L35761   Non-Invasive Peripheral Arterial Vascular Studies, Revision Effective Date 10/26/2023 [95]   
  • A57593   Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies, Revision Effective Date 10/1/2023  [96]
  • A57846   Response to Comments: DL37228 Wound Care, Original Effective Date 02/09/2020 [100]
  • A56232   Billing and Coding: Foot Care, Revision Effective Date 10/01/2024 [97]
  • L39865   Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Revision Effective Date 01/01/2026 [98]
  • A59740  Billing and Coding: Skin Substitutes Grafts/Cellular Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, Revision Effective Date 01/01/2026 [99]
  • A59954  Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers DL39865, Revision Effective Date 01/01/2026 [100]

National Coverage Determinations
  • NCD 280.6  Pneumatic Compression Devices [101]

Local Coverage Determinations (LCDs) Development and Reconsideration Processes

All stakeholders are encouraged to participate in the LCD Process as well as the LCD Reconsideration Process. Recent regulations have made both processes transparent and open to everyone, including Medicare beneficiaries. For more information, consult the MLN Matters document on the topic MM10901.[102]  
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REFERENCES

  1. CGS. Local Coverage Determination (LCD): Non-Invasive Vascular Studies (L34045) . 2019;.
  2. CGS. Billing and Coding: Non-Invasive Vascular Studies A56697 . 2019;.
  3. CGS Administrators. Local Coverage Determination (LCD): Outpatient Physical and Occupational Therapy Services (L34049) . 2015;.
  4. CGS Administrators, LLC et al. Local Coverage Article: Billing and Coding: Outpatient Physical and Occupational Therapy Services (A57067) . 2019;.
  5. CGS Administrators, LLC et al. LCD: Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities (L36690) . 2022;.
  6. CGS Administrators, LLC et al. Billing and Coding: Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities (A56696) . 2019;.
  7. CGS Administrators, LLC et al. Response to Comments: Wound Application of Cellular and/or Tissue Based products (CTPs), Lower Extremities (A55276) . 2016;.
  8. CGS Administrators, LLC et al. Local Coverage Determination (LCD): DEBRIDEMENT Services (L34032) . 2022;.
  9. CGS Administrators, LLC et al. Local Coverage Article: Billing and Coding for DEBRIDEMENT Services (A56459) . 2022;.
  10. CGS Administrators, LLC et al. Physical Therapy - Home Health (L33942) . 2015;.
  11. CGS Administrators, LLC et al. Billing and Coding: Physical Therapy - Home Health (A57311) . 2019;.
  12. CGS Administrators, LLC, Noridian Healthcare Solutions, LLC et al. Local Coverage Determination: Pressure Reducing Support Surfaces - Group 1(L33830) . 2015;.
  13. Noridian Healthcare Solutions, LLC, CGS Administrators LLC et al. Local Coverage Article: Pressure Reducing Support Surfaces - Group 1 - Policy Article (A52489) . 2017;.
  14. CGS Administrators, LLC, Noridian Healthcare Solutions, LLC et al. Local Coverage Determination: Pressure Reducing Support Surfaces - Group 2 (L33642) . 2015;.
  15. CGS Administrators, LLC, Noridian Healthcare Solutions, LLC et al. Local Coverage Article: Pressure Reducing Support Surfaces - Group 2 - Policy Article (A52490) . 2015;.
  16. CGS Administrators, LLC, Noridian Healthcare Solutions, LLC et al. Local Coverage Determination: Pressure Reducing Support Surfaces - Group 3 (L33692) . 2015;.
  17. CGS Administrators, LLC, Noridian Healthcare Solutions, LLC et al. Local Coverage Article: Pressure Reducing Support Surfaces - Group 3 - Policy Article (A52468) . 2015;.
  18. CGS Administrators and Noridian. Response to Comments: Pneumatic Compression Devices - DL33829 (A59219) . 2023;.
  19. CGS Administrators, LLC and Noridian Healthcare Solutions, LLC et al. Local Coverage Determination for Negative Pressure Wound Therapy Pumps (L33821) . 2015;.
  20. CGS Administrators, LLC et al. Local Coverage Article: Negative Pressure Wound Therapy Pumps - Policy Article (A52511) . 2015;.
  21. Center for Medicare and Medicaid Services (CMS), et al. Local Coverage Determination for Surgical Dressings (L33831) . 2015;.
  22. Centers for Medicare and Medicaid Services, et al. Local Coverage Article for Surgical Dressings - Policy Article (A54563) . 2015;.
  23. CGS Administrators, LLC et al. Low frequency, non-contact, non-thermal ultrasound (CPT code 97610) (A56175) . 2018;.
  24. Centers for Medicare and Medicaid Services. Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426) . 2017;.
  25. CGS Administrators, LLC et al. L39756 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  26. CGS Administrators, LLC et al. A59618 Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2025;.
  27. CGS Administrators, LLC et al. A59941 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2026;.
  28. First Coast Service Options. Local Coverage Determination (LCD): Wound Care (L37166) . 2017;.
  29. First Coast Service Options, Inc. et al. Billing and Coding: Wound Care (A55818) . 2017;.
  30. First Coast Service Options, Inc. et al. Local Coverage Article: WOUND CARE (L37166): Medicare Part A/B local coverage determination (LCD) comment summary (A55757) . 2017;.
  31. First Coast Service Options, Inc. et al. Duplex Scan Of Lower Extremity Arteries (L33667) . 2015;.
  32. First Coast Service Options, Inc. et al. Non-Invasive Evaluation of Extremity Veins (L33693) . 2015;.
  33. First Coast Service Options, Inc. et al. Local Coverage Determination (LCD): Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries (L33696) . 2015;.
  34. First Coast Service Options, Inc. et al. LCD: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities (L36377) . 2015;.
  35. First Coast Service Options, Inc et al. Billing and Coding: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities (A57680) . 2018;.
  36. First Coast Service Options, Inc. et al. L36377: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2015;.
  37. First Coast Service Options, Inc. et al. A57680: Billing and Coding: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2018;.
  38. First Coast Service Options, Inc. et al. Local Coverage Determination (LCD) Treatment of Chronic Venous Insufficiency of the Lower Extremities L38720 . 2020;.
  39. First Coast Service Options, Inc. et al. Response to Comments: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A59518) . 2023;.
  40. First Coast Service Options, Inc. et al. A59824 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  41. National Government Services, Inc. et al. Local Coverage Determination (LCD): Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures (L33563) . 2015;.
  42. National Government Services, Inc. et al. Local Coverage Determination (LCD): Debridement Services (L33614) . 2015;.
  43. National Government Services, Inc. et al. Local Coverage Article: Billing and Coding: Debridement Services (A56617) . 2019;.
  44. National Government Services, Inc. et al. Non-Invasive Vascular Studies (L33627) . 2015;.
  45. National Government Services. Local Coverage Determination (LCD): Outpatient Physical and Occupational Therapy Services (L33631) . 2015;.
  46. National Government Services, Inc. et al. Billing and Coding: Outpatient Physical and Occupational Therapy Services (A56566) . 2019;.
  47. National Government Services, Inc. et al. Billing and Coding: Routine Foot Care and Debridement of Nails (A57759) . 2019;.
  48. National Government Services, Inc. et al. L39828 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  49. National Government Services, Inc. et al. A59953 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  50. National Government Services, Inc. et al. A59712 Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  51. Noridian Healthcare Solutions LLC. Local Coverage Article: Wound Care and Debridement - Provided by a Therapist, Physician, NPP, or as Incident-to Services (A53046) . 2015;.
  52. Noridian. Local Coverage Article: WOUND Care & Debridement – Provided by a Therapist, Physician, NPP or as Incident-to Services (A53296) . 2015;.
  53. Noridian Healthcare Solutions, LLC et al. Local Coverage Article: Billing and Coding: Lymphedema Decongestive Treatment (A52959) . 2015;.
  54. Noridian Healthcare Solutions LLC. Local Coverage Article: Lymphedema Decongestive Treatment (A55710) . 2017;.
  55. Noridian. Local Coverage Article: Coverage of Foot CARE Services (A52918) . 2015;.
  56. Noridian. Response to Comments: Treatment of Varicose Veins of Lower Extremities A54710 . 2016;.
  57. Noridian. Response to Comments: Treatment of Varicose Veins of Lower Extremities A54713 . 2016;.
  58. Noridian. Response to Comments: Treatment of Varicose Veins of Lower Extremities A54714 . 2016;.
  59. Noridian. Response to Comments: Treatment of Varicose Veins of Lower Extremities A54715 . 2016;.
  60. Noridian Healthcare Solutions, LLC et al. Billing and Coding: JW and JZ Modifier Billing Guidelines (A55932) . 2018;.
  61. Noridian Healthcare Solutions, LLC et al. Billing and Coding: JW and JZ Modifier Billing Guidelines (A53024) . 2015;.
  62. Noridian Healthcare Solutions, LLC et al. L39764 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  63. Noridian Healthcare Solutions, LLC et al. L39760 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  64. Noridian Healthcare Solutions, LLC et al. A59626 Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  65. Noridian Healthcare Solutions, LLC et al. A59628 Billing and Coding: Skin Substitutes Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  66. Noridian Healthcare Solutions, LLC et al. A59952 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  67. Noridian Healthcare Solutions, LLC et al. A59950 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  68. Novitas Solutions. Local Coverage Determination (LCD): Wound Care (L35125) . 2015;.
  69. Novitas Solutions Inc. Local Coverage Article: Billing and Coding: Wound Care (A53001) . 2015;.
  70. Novitas Solutions, Inc. et al. LCD: Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds (L35041) . 2015;.
  71. Novitas Solutions, Inc. et al. Billing and Coding: Billing and Coding: Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds (A54117) . 2015;.
  72. Novitas Solutions, Inc. et al. L35041: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2015;.
  73. Novitas Solutions, Inc. et al. A54117: Billing and Coding: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2015;.
  74. Novitas Solutions, Inc. et al. Response to Comments: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A59517) . 2023;.
  75. Novitas Solutions, Inc. et al. A59823 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2026;.
  76. Novitas. Local Coverage Determination (LCD) Treatment of Chronic Venous Insufficiency of the Lower Extremities L34924 . 2015;.
  77. Palmetto GBA. Outpatient Physical Therapy (L34428) . 2015;.
  78. Palmetto GBA. Outpatient Occupational Therapy (L34427) . 2015;.
  79. Palmetto GBA. Billing and Coding: Home Health Occupational Therapy (A53057) . 2015;.
  80. Palmetto GBA. Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy (A56731) . 2019;.
  81. Palmetto GBA. Billing and Coding: Outpatient Physical Therapy (A53065) . 2015;.
  82. Palmetto GBA. Local Coverage Article: Billing and Coding: Spiracur SNaP® WOUND CARE System (A53781) . 2015;.
  83. Palmetto GBA. Local Coverage Article: Low frequency, non-contact, non-thermal ultrasound (CPT code 97610) (A54555) . 2015;.
  84. Palmetto GBA. Billing and Coding: Outpatient Occupational Therapy (A53064) . 2015;.
  85. Palmetto GBA. Local Coverage Article: Low frequency, non-contact, non-thermal ultrasound (CPT code 97610) (A53773) . 2015;.
  86. Palmetto. Local Coverage Determination (LCD): Treatment of Varicose Veins of the Lower Extremities (L39121) . 2022;.
  87. Palmetto. Response to Comments: Treatment of Varicose Veins of the Lower Extremities A59001 . 2022;.
  88. Palmetto GBA. Response to Comments: Near-Infrared Spectroscopy in Wound and Flap Management (A59281) . 2022;.
  89. Palmetto GBA. A59945 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2026;.
  90. Palmetto GBA. L39806 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2024;.
  91. Palmetto GBA. A59691 Billing and Coding: Skin Substitutes Grafts/Cellular Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2025;.
  92. Wisconsin Physicians Service Insurance Corporation. Local Coverage Determination (LCD): WOUND CARE (L37228) . 2018;.
  93. Wisconsin Physicians Service Insurance Corporation. Local Coverage Article: Response to Comments: WOUND CARE (DL37228) (A55910) . 2018;.
  94. Wisconsin Physicians Service Insurance Corporation. Local Coverage Article: Billing and Coding: Wound Care (A55909) . 2018;.
  95. Wisconsin Physicians Service Insurance Corporation . Non-Invasive Peripheral Arterial Vascular Studies (L35761) . 2019;.
  96. Wisconsin Physicians Service Insurance Corporation. Local Coverage Article: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies (A57593) . 2019;.
  97. Wisconsin Physicians Service Insurance Corporation (WPS). Billing and Coding: Foot Care (A56232) . 2019;.
  98. WPS Insurance Corporation. L39865 Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2026;.
  99. WPS Insurance Corporation. A59740 Billing and Coding: Skin Substitutes Grafts/Cellular Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers . 2026;.
  100. WPS Insurance Corporation. A59954 Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers DL39865 . 2026;.
  101. . National Coverage Determination (NCD) for Pneumatic Compression Devices (280.6) [Internet] . 2018;.
  102. CMS Medicare Learning Network. Local Coverage Determinations (LCDs) - MM10901 MLN Matters. 2019;.
Topic 1428 Version 25.7
7/18/2025 5:38:00 PM
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