| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
C9363 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Skin substitute, integra meshed bilayer wound matrix, per square centimeter |
| HCPCS Short Description |
Integra meshed bil wound mat |
| HCPCS Pricing Indicator Code 1 |
53 - Statute |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Statute Number |
621MMA |
| HCPCS Coverage Code |
D - Special coverage instructions apply |
| HCPCS Berenson-Eggers Type Of Service Code |
D1A - Medical/surgical supplies |
| HCPCS Type Of Service Code 1 |
9 - Other medical items or services |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
7/1/2009 |
| HCPCS Action Effective Date |
1/1/2014 |
| HCPCS Action Code |
N - No maintenance for this code |