In simple words: EpiFix is a skin graft material made from the membrane surrounding a baby during pregnancy. It's used to help heal wounds like burns and ulcers.

EpiFix is a dehydrated allograft derived from human amniotic membrane, used to promote new tissue formation and wound healing. It is supplied in injectable form and is reported per milligram.

Example 1: A patient with a chronic, full-thickness ulcer on the lower extremity receives an injection of 10 mg of EpiFix to stimulate tissue growth and promote wound closure., A patient with a partial-thickness burn is treated with a series of EpiFix injections, with the dosage adjusted based on the wound size and healing progress., A patient undergoes a skin grafting procedure using EpiFix after surgical removal of a lesion, with the material applied directly to the wound bed.

Documentation should include the diagnosis, wound size and location, the amount of EpiFix administered, and medical necessity for the use of this skin substitute.

** This code was deleted as of August 19, 2021, because it was not FDA approved for the indications in policy L36690. Q-codes are temporary codes. Prior to its deletion, Medicare considered many skin substitutes experimental and not medically necessary, so checking with payers for coverage was necessary. Medicare has classified skin substitutes by cost, impacting how they're packaged with surgical procedures.