All PlansCoverageMedium impact
Bioengineered Skin and Soft Tissue Substitutes
Blue Cross & Blue Shield of Mississippi·MS · Plastic Surgery, Wound Care, General Surgery +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This policy establishes coverage criteria for bioengineered skin and soft tissue substitutes, including acellular dermal matrix (ADM) products used in wound care, breast reconstruction, and other soft tissue repairs. The policy clarifies FDA regulatory requirements and notes that ADM use in breast reconstruction requires pre-market approval evaluation.
Action Required
Review current billing practices for bioengineered skin substitutes and ADM products. Ensure proper documentation of medical necessity for wound care applications. For breast reconstruction cases using ADM, verify coverage determination processes are in place since FDA has not determined safety and effectiveness for this indication. Update prior authorization workflows if needed based on specific product usage.