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May 2013 CSHCN Services Program Provider Manual

17 Durable Medical Equipment (DME) : Benefits, Limitations, and Authorization Requirements : Burn Care Garments

17.3.4 Burn Care Garments
The CSHCN Services Program may reimburse providers for burn care products. The burn must be second or third degree with hypertrophic scarring, and the garment must be specific to the location of the burn. Burn care management garments may also be considered for reimbursement for other conditions (e.g., large hemangiomas or lymphangiomas), with documentation from the physician regarding medical necessity. Providers must use the following procedure codes when submitting claims for burn care services:

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