Topic

StrataGraft (allogeneic cultured keratinocytes & fibroblasts in murine collagen-dsat)

A collection of 29 issues

The Complete Requirements Checklist to Get StrataGraft Covered by Blue Cross Blue Shield in Illinois (2024 Forms and Appeals Guide)

Answer Box: Getting StrataGraft Covered by BCBS Illinois StrataGraft requires prior authorization from Blue Cross Blue Shield of Illinois for deep partial-thickness thermal burns. Your fastest path to approval: (1) Verify your plan covers bioengineered skin substitutes under Illinois Public Act 103-0123, (2) Submit complete PA documentation including burn depth

How to Get StrataGraft Covered by Blue Cross Blue Shield in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Getting StrataGraft Covered by BCBS Ohio StrataGraft requires prior authorization from Blue Cross Blue Shield Ohio for adults with deep partial-thickness thermal burns when surgical intervention is clinically indicated. The fastest path to approval: (1) Ensure patient meets FDA criteria—adults with intact dermal elements, (2) Submit comprehensive

Getting StrataGraft Covered by Cigna in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting StrataGraft Covered by Cigna in North Carolina StrataGraft requires prior authorization from Cigna for deep partial-thickness thermal burns in adults. The fastest path to approval involves submitting a complete PA request with burn specialist documentation, wound measurements, and photos using HCPCS code J7353. If denied, North Carolina

How to Get StrataGraft Approved by Aetna CVS Health in Virginia: Complete Prior Authorization & Appeals Guide

Quick Answer: Getting StrataGraft Covered by Aetna CVS Health in Virginia StrataGraft requires prior authorization from Aetna CVS Health and must be billed as a facility procedure (HCPCS J7353), not through pharmacy benefits. You'll need comprehensive burn documentation, surgical consultation, and medical necessity justification. If denied, Virginia offers

Getting StrataGraft Covered by Aetna CVS Health in Texas: Prior Authorization, Appeals & Cost-Saving Strategies

Answer Box: Getting StrataGraft Covered by Aetna CVS Health in Texas StrataGraft requires prior authorization through Aetna's medical benefit (not pharmacy) for adults with deep partial-thickness thermal burns. The fastest path: 1) Confirm your burn meets FDA criteria with your physician, 2) Submit prior authorization with complete medical

How to Get StrataGraft Covered by UnitedHealthcare in Michigan: Prior Authorization Guide and Appeals Timeline

Quick Answer: Getting StrataGraft Covered by UnitedHealthcare in Michigan StrataGraft requires prior authorization from UnitedHealthcare as a facility-billed medical benefit (not pharmacy). The fastest path: Submit PA through the UHC Provider Portal with complete burn documentation, wound measurements, and proof that autograft isn't feasible. Standard decisions take up

Do You Qualify for StrataGraft Coverage by Blue Cross Blue Shield in California? Decision Tree & Next Steps

Quick Answer: StrataGraft Coverage Eligibility You likely qualify for StrataGraft coverage if you're an adult with deep partial-thickness thermal burns where surgical intervention is clinically indicated. Blue Cross Blue Shield California requires prior authorization through your hospital's utilization management team using HCPCS code Q4199 (medical benefit,

How Long Does It Take to Get StrataGraft Approved by Blue Cross Blue Shield in New Jersey? Timeline & Milestones

Answer Box: Getting StrataGraft Approved in New Jersey Timeline: Standard Blue Cross Blue Shield prior authorization takes 30 days; expedited urgent cases receive decisions within 72 hours. After internal denial, New Jersey's IHCAP external review takes 45 days (expedited cases within days). Fastest path: Submit complete documentation through

Coding That Helps Get StrataGraft Approved in Pennsylvania with Blue Cross Blue Shield (ICD-10, HCPCS J7353, NDC)

Quick Answer: StrataGraft requires prior authorization from Blue Cross Blue Shield in Pennsylvania, billed under HCPCS code J7353 as a medical benefit (not pharmacy). Use ICD-10 codes T20-T25 for burn location plus T31 for body surface area. Calculate units as actual cm² treated (each unit = 100 cm²). Submit PA with

How to Get StrataGraft Approved by Cigna in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting StrataGraft Covered by Cigna in New York StrataGraft requires prior authorization under Cigna's medical benefit (not pharmacy) in New York. The fastest path to approval: 1) Confirm your provider is in-network, 2) Submit Cigna's tissue-engineered skin substitute PA form with complete burn documentation