Traditional MedicareCoverageHigh impact
Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities
Medicare/CMS - LCD·Wound Care, General Surgery, Podiatry +1 more·Local Coverage Determination
Effective date
Sep 3, 2026
We identified it
Sep 3, 2026
Summary
This is a newly issued Local Coverage Determination (LCD L36690) from CGS Administrators that establishes coverage policies for cellular and tissue-based products (CTPs) applied to lower extremity wounds under Medicare Part A and Part B. The policy becomes effective 9/3/2026 and will govern billing, medical necessity requirements, and coverage determinations for wound care applications in the lower extremities.
Action Required
By September 3, 2026: Billing team must obtain and review the complete LCD L36690 policy text from CGS Administrators to identify all specific CPT and HCPCS codes affected by this coverage determination. Once codes are identified, update billing software with any new coverage rules, prior authorization requirements, or documentation standards. Providers must be notified of any changes to CTP billing for lower extremity wounds. Obtain copies of the full policy from https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=36690&ver=39 and distribute to all relevant clinical staff. Non-compliance with this LCD's requirements will result in claim denials for non-compliant CTP applications.