Table of content for "Low cost skin substitute app" (HCPCS C5274)
General information on the “C5274” code
HCPCS Code: C5274
Long Description: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
Short Description: Low cost skin substitute app
Original information is taken from C5274 page
Pricing indicators
Pricing Indicator Code 1: 53 – Statute
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): P5A – Ambulatory procedures - skin
Type Of Service 1: 2 – Surgery
Type Of Service 2: F – Ambulatory surgical center (facility usage for surgical services)
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20140101
Code Effective Date: 20140101
Action Code: N – No maintenance for this code