Summary & Overview
HCPCS C1849: Synthetic Resorbable Skin Substitute, Per sq cm
HCPCS Level II code C1849 designates a synthetic, resorbable skin substitute billed per square centimeter for wound coverage and tissue repair. As an itemized supply code, C1849 matters nationally because it standardizes reporting and reimbursement for advanced wound care materials used across outpatient and procedural settings. Use of synthetic resorbable matrices has clinical implications for healing timelines, grafting strategies, and cost-containment in complex wound management.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of national reimbursement considerations, typical sites of service, and the clinical context for use of synthetic, resorbable skin substitutes. The publication summarizes benchmarks where available, highlights common billing modifiers and operational notes, and situates C1849 within wound-care service lines. It also outlines documentation and coding elements that influence coverage decisions and billing consistency.
This summary is intended to inform healthcare administrators, revenue cycle staff, and clinicians about the role of HCPCS Level II code C1849 in contemporary wound-care practice and payer interactions.
Billing Code Overview
HCPCS Level II code C1849 describes a skin substitute, synthetic, resorbable, billed per square centimeter. This item is a biologic dressing intended for temporary or permanent coverage of wounds where a synthetic, resorbable matrix supports tissue repair and healing.
Service Type: Skin substitute application / wound care material
Typical Site of Service: Outpatient wound care clinics, hospital outpatient departments, and ambulatory surgery centers, where clinicians apply or implant the synthetic, resorbable skin substitute as part of wound management or reconstructive procedures.
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Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a chronic, non-healing lower-extremity full-thickness wound after debridement receives a synthetic, resorbable skin substitute applied to the wound bed to promote closure. The wound is measured and the product is supplied and billed per square centimeter using C1849. Typical workflow: wound assessment and debridement in an outpatient wound clinic, operating room, or clinic procedure room; measurement and selection of the appropriate size of the synthetic resorbable skin substitute; application to the prepared wound bed with securement (dressings and possible negative-pressure wound therapy); documentation of product square centimeters used; post-application instructions and scheduled follow-up visits for dressing changes and evaluation of graft take and healing. Typical sites of service include outpatient wound centers, ambulatory surgery centers, hospital outpatient departments, and clinic procedure rooms. Common patient scenarios include diabetic foot ulcers, venous stasis ulcers, pressure injuries, and complex surgical or traumatic soft-tissue defects where a resorbable synthetic skin substitute is indicated to support re-epithelialization and tissue regeneration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required is substantially greater than typically required for application (documented justification). |