Medicare AdvantageBilling CodesMedium impact
MA11.015ae, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds
Independence Blue Cross·Wound Care, Dermatology, General Surgery +3 more·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage policy MA11.015ae has been superseded by MA11.015ah, which adds 18 new HCPCS codes (A2036-A2039, Q4383-Q4397) for bioengineered skin substitutes effective 10/01/2025. The policy covers wound care treatments including burns, chronic non-healing wounds, and post-surgical applications when specific medical necessity criteria are met. Billing teams must update systems to recognize these new codes as medically necessary for Medicare Advantage members.
Action Required
By 10/01/2025: Billing team must update billing software to recognize the 18 newly added HCPCS codes (A2036, A2037, A2038, A2039, Q4383-Q4390, Q4392-Q4397) as medically necessary for Medicare Advantage beneficiaries. Update claim scrubbing rules to accept these codes when submitted with appropriate ICD-10 diagnosis codes for lower extremity chronic non-healing wounds, burns, acute wounds, post-Mohs, or post-surgical wounds. Providers should document all required medical necessity criteria per policy (wound size ≥1.0 cm², clean granular base, adequate circulation, failed conservative therapy timeframes). Ensure prior authorization workflows reference the updated MA11.015ah policy (not superseded MA11.015ae). Failure to update billing rules may result in claim denials for these newly covered codes.