Does A2043 require prior authorization?

No, A2043 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for A2043?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Procedure codes on Medical Policy documents are included only as a general reference tool and may not be all-inclusive.
The presence or absence of procedure/service/supply/device codes in the policy does not determine benefit coverage or reimbursement; only the written coverage position should be used for determinations.

Medically necessary use of allogeneic acellular dermal matrix products for breast reconstruction when there is insufficient tissue expander/implant coverage, or compromised/thin postmastectomy skin flaps at risk of dehiscence/necrosis, or undermined inframammary/lateral folds needing reestablishment.
Medically necessary: Breast reconstructive surgery using allogeneic acellular dermal matrix products (AlloDerm, Cortiva, DermACELL, DermaMatrix, FlexHD, FlexHD Pliable) when there is insufficient tissue expander/implant coverage, or compromised/thin postmastectomy skin flaps at risk of dehiscence/necrosis, or undermined inframammary/lateral folds requiring landmark reestablishment.
Medically necessary use of allogeneic acellular dermal matrix (ADM) products for breast reconstruction when there is insufficient coverage by tissue expander/implant, or compromised/thin skin flaps at risk of dehiscence/necrosis, or undermined inframammary/lateral folds needing landmark reestablishment.
Porcine (pig) skin dressings are covered by CMS as occlusive dressings for burns, donor sites of a homograft, and decubiti and other ulcers when reasonable and necessary for the individual patient.

BCBSIL-SUR704.012, Bioengineered Skin and Soft Tissue Substitutes

BCBSMT-SUR704.012, Bioengineered Skin and Soft Tissue Substitutes

BCBSNM-SUR704.012, Bioengineered Skin and Soft Tissue Substitutes

BCBSOK-SUR704.012, Bioengineered Skin and Soft Tissue Substitutes