Wiki Puraply

[kendalb]

How is Puraply billed as a pass through item for Medicare?

 

[CodingKing]

Code is C9349 for the supply

 

[kendalb]

We are billing it using C9349 but Medicare is still denying it. Should a modifier be added?

 

[CodingKing]

Which MAC?

I could only find 2 LCD's on this

L34053 through CGS which mentions modifiers:

JC- skin substitute used as a graft
JD -Skin substitute not used as a graft​

It also mentions DX codes allowed relating to diabetic complications

Novitas LCD L35041, makes no mention of modifiers or DX codes for coverage. It does however in the associated Article mention that:

HCPCS code C9349 encompasses more than one type of product. Therefore, claims reporting HCPCS code C9349 must include the name of the product that was used in line 19 of the CMS-1500 form or the electronic equivalent.

 

[kendalb]

The MAC here in South Carolina is Palmetto GBA.

Which MAC?

I could only find 2 LCD's on this

L34053 through CGS which mentions modifiers:

JC- skin substitute used as a graft
JD -Skin substitute not used as a graft​

It also mentions DX codes allowed relating to diabetic complications

Novitas LCD L35041, makes no mention of modifiers or DX codes for coverage. It does however in the associated Article mention that: