DLEU and VLU
Policy No.
S-249-001
States
Grafix Core Q4132
Commercial - Not Covered
Medicare Advantage - DFU/VLU/DLEU/Other wounds based on medical necessity
Medicaid - Follows Medicaid Fee-For-Service
Grafix PL/Prime Q4133
Commercial - DLEU /VLU
Medicare Advantage - DFU/VLU/DLEU/Other wounds based on medical necessity
Managed Medicaid - Follows Medicaid Fee-For-Service