The Medicare Advantage Coverage Summary applies to certain wound treatments, skin substitutes

UnitedHealthcare’s Medicare Advantage Coverage Summary — Wound Treatments explains our coverage criteria for skin substitutes for Medicare Advantage members. This coverage criteria follows CMS LCDs/LCAs, where applicable. 

For states/territories with no LCDs/LCAs, the Medicare Advantage Coverage Summary directs providers to the UnitedHealthcare Commercial Medical Policy titled UnitedHealthcare Commercial and Individual Exchange Medical Policy: Skin and Soft Tissue Substitutes to determine if the skin substitute to be used will be covered. Based on a review of medical claims, if the coverage criteria are not met or records are not submitted (if requested), claims may be denied. 

Questions?

For additional information, refer to the UnitedHealthcare Medicare Advantage Coverage Summary.

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