Apligraf

An FDA-approved living cell therapy and bioengineered skin substitute used in chronic wound care, including diabetic foot ulcers and venous leg ulcers. Denied in Michael Kissling's case across multiple appeals — a documented example of Prior Knowledge OmissionPrior Knowledge OmissionA denial issued without referencing documented clinical evidence already present in the patient's medical record that establishes medical necessity. resulting in progressive wound failure and eventual amputation.