National Coverage Determination (NCD) 270.3 Blood-Derived Products for Chronic, Non-Healing Wounds

Published 02/02/2022

Effective for claims with dates of service on and after April 13, 2021, CMS will nationally cover autologous Platelet-Rich Plasma (PRP) for the treatment of chronic non-healing diabetic wounds under Section 1862(a)(1)(A) of the Social Security Act (the Act) for a duration of 20 weeks. This applies when using devices whose FDA-cleared indications include the management of exuding cutaneous wounds, such as diabetic ulcers. Effective for claims with dates of services on or after April 13, 2021, PRP claims for chronic, non-healing, diabetic wounds should contain HCPCS code G0460, an ICD-10 diagnosis code for Diabetes Mellitus and an ICD-10 diagnosis code for Chronic Ulcer.

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