Coverage & Reimbursement Support by
Triad Life Sciences®

Triad Life Sciences is partnering with our customers to provide reimbursement support, including insurance verifications, payor trends, and claims and prior authorization support.

Need Help?

Contact us: 888.767.4849
[email protected]

Our Reimbursement Team Can Support You With:

Benefit Verification

Our team of experienced verification specialists can help you verify patient-specific coverage for Triad Life Sciences® products. Verification typically occurs within 24-48 hours.

Codingand Billing Questions

Our reimbursement team can help answer your coding and billing questions about Triad Life Sciences® products

Prior Authorization Support

Triad’s reimbursement team can help you with prior authorization needs, including templates for letters of medical necessity and submission directions.

Overview of Key Steps

Step 1

Provider Identifies Patient

Step 2

Provider completes Patient Intake Forms

Step 3

Triad’s verification specialists will conduct the insurance verification and notify Provider with the coverage details.

Step 4

Provider contacts Triad Customer Service to place order for product.

Get Started

Download Reimbursement Guide
Download Insurance Verification

Application Codes

CPT Code1 Medicare Non-Facility (Office) Rate2 CPT Description
15271 $155.19 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq. cm; first 25 sq. cm or less wound surface area
+15272 $25.19 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq. cm; each additional 25 sq. cm wound surface area or part thereof
15273 $318.10 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq. cm; first 100 sq. cm wound surface area or 1% of body area of infants and children
+15274 $84.31 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq. cm; each additional 100 sq. cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
15275 $159.55 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq. cm; first 25 sq. cm or less wound surface area
+15276 $32.58 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq. cm; each additional 25 sq. cm wound surface area, or part thereof (List separately in addition to code for primary procedure)
15277 $349.00 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or equal to 100 sq. cm; first 100 sq. cm wound surface area, or 1% body area of infants and children
+15278 $97.41 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq. cm; each additional 100 sq. cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
  1. CPT is a registered trademark of the American Medical Association (AMA)
  2. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched, rates are national averages

Surgical Site Preparation Codes

Code Description
15002 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq. cm or 1% of body area of infants and children
+15003 Each additional 100 sq. cm, or part thereof, or each additional 1% of body area of infants and children
(List separately in addition to code for primary procedure)
15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq. cm or 1% of body area of infants and children
+15005 Each additional 100 sq. cm, or part thereof, or each additional 1% of body area of infants and children
(List separately in addition of code for primary procedure)
  1. Coverage for the surgical site preparation codes varies. Please review payor guidelines.
  2. Per coding guidelines, site preparation codes are billed once per wound.
  3. The application code is subject to the multiple procedure reduction rule if billed on the same day as the surgical site preparation code.

Need to know which MAC you are in?

This information in this document is not an affirmative instruction as to which codes and modifiers to use for a particular service, supply, procedure or treatment. It is the provider’s responsibility to determine and submit the appropriate codes and modifiers for any service, supply, procedure or treatment rendered. Actual codes and/or modifiers used are at the sole discretion of the treating physician and/or facility. Local payers and physician specialty societies should be contacted for specific coding guidelines. Triad Life Sciences cannot guarantee medical benefit coverage or reimbursement with the codes listed in this document.

Triad Life Sciences®, Inc.

is an emerging regenerative medicine company with a groundbreaking FDA-cleared technology platform engineered to address unmet clinical needs in complex surgical wounds, chronic stalled wounds, and burns. Triad’s proprietary, patent-pending technology provides innovative treatment solutions derived from our naturally occurring extracellular matrix (ECM) material and its related bioactive properties.


INNOVATIVE

The InnovaMatrix® Platform is the only placental-derived medical device technology on the market to address the inherent challenges and related restrictions of Human Cells, Tissue, and Cellular and Tissue-Based Products (HCT/Ps). This patent-pending technology provides an array of regenerative medicine opportunities and is the foundation for Triad’s robust product development pipeline.

RELIABLE

InnovaMatrix® Platform provides a reliable solution in medical device form where the current HCT/P placental technologies are fraught with substantial donor variability, thereby resulting in inconsistent products. Produced under the stringent requirements of Current Good Manufacturing Practice (CGMP) with a highly controlled source material, the InnovaMatrix® Platform is a consistent and reproducible alternative for wound care management.

AFFORDABLE

Triad’s mission is to provide safe, cost-effective wound care solutions to the market. To that end, Triad’s state-of-the-art, scalable manufacturing operation maximizes efficiency and creates economic benefits for the patients, healthcare providers, and payors.