Bio-Engineered Skin and Soft Tissue Substitutes

When Policy Topic is covered Breast reconstructive surgery using allogeneic acellular dermal matrix products* (i.e., AlloDerm®, AlloMaxTM, DermaMatrixTM, FlexHD®, GraftJacket®) may be considered medically necessary,  when there is insufficient tissue expander or implant coverage by the pectoralis major muscle and additional coverage is required,  when there is viable but compromised or thin post-mastectomy skin flaps that are at risk of dehiscence or necrosis, or  the infra-mammary fold and lateral mammary folds have been undermined during mastectomy and re-establishment of these landmarks is needed.