| HCPCS Code: |
C9363 |
| Long Description: |
Skin substitute, integra meshed bilayer wound matrix, per square centimeter |
| Short Description: |
Integra meshed bil wound mat |
| Pricing Indicator 1: |
53 (Statute) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
621MMA |
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
D1A (Medical/surgical supplies) |
| Type of Service Code 1: |
9 (Other medical items or services) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-07-2009 |
| Action Effective Date: |
01-01-2014 |
| Action Code: |
P (Payment change (MOG, pricing indicator codes, anesthesia base units,Ambulatory Surgical Centers)) |
