I deal with a lot of wound care billing involving various types of grafts. First, here is a link to the company that makes the graft, and billing procedures depending on type of provider/facility:http://mtfwoundcare.org/www/reimbursement/Next, there should be a graft representative/billing reimbursement specialist for MTF Wound Care(who makes AmnioBand) that you can contact for advice/help. You need to enlist them to help you fight these denials, that is part of what they are there for. They should have also run benefits/coverage on the patient first, because generally if the graft doesn't get paid, and the provider did everything right, the graft company is on the hook for the cost of the grafts, as opposed to the provider. So it is in their best interest to make sure the graft will be covered first. Finally, it could turn out to be that this patient's insurance will not cover this particular graft brand, for whatever reason(experimental, investigational, etc). They may cover a different graft brand, or they simply may not cover these types of grafts at all. Or, it could be they don't feel it is medically necessary if not enough conservative treatment was rendered first to the patient. Often, insurances will want documentation of at least four weeks(sometimes more) of conservative treatment before grafts are used.