MedicaidCoverageHigh impact
Skin Substitution Services and Products Open for Billing for Wound Care Management
Nevada Medicaid·NV · Wound Care, Plastic Surgery, General Surgery +1 more·Billing & Coding
Effective date
Aug 28, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid is now covering additional skin substitute services for wound care management, effective August 28, 2024. Three HCPCS codes (Q4133, Q4186, Q4101) require prior authorization with treatment plans, while eight CPT codes (15271-15278) for skin substitute application do not require prior auth.
Action Required
Immediately: Update billing system to enable HCPCS codes Q4133, Q4186, Q4101 and CPT codes 15271-15278 for Nevada Medicaid. Configure prior authorization requirements for Q4133, Q4186, Q4101. Train providers to submit signed wound care treatment plans or medical necessity letters within 30 days of service for HCPCS codes. Update encounter forms to remind providers of documentation requirements. Previously denied claims with error code 4801 will be automatically reprocessed.