Commercial DFU
Medicare Advantage DFU, VLU, DLEU
Policy No.
68
States
Grafix Core Q4132
Commercial – Covered - DFU/VLU/VSU
Medicare Advantage – Follows Active LCD
Retired LCD – Follows Commercial
Grafix PL/Prime Q4133
Commercial – Covered - DFU/VLU/VSU
Medicare Advantage – Follows Active LCD
Retired LCD – Follows Commercial