Skip to Main Content

Skin Substitute Prior Authorization Changes (Effective 10/16/2025)

Effective October 16, 2025 the following skin substitute codes with require prior authorization:

 

Code

Code Description

15271

Skin Sub Graft Trnk/Arm/Leg

15272

Skin Sub Graft T/A/L Add-On

15273

Skin Sub Grft T/Arm/Lg Child

15274

Skn Sub Grft T/A/L Child Add

15275

Skin Sub Graft Face/Nk/Hf/G

15276

Skin Sub Graft F/N/Hf/G Addl

15277

Skn Sub Grft F/N/Hf/G Child

15278

Skn Sub Grft F/N/Hf/G Ch Add

Last Updated: 08/20/2025