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Medical Coding News Archives

Skin Replacement Codes Are Revamped for 2012

 
January 25, 2012:

Nichole VanHorn, Clinical/Technical Editor

CPT codes for skin replacement have changed significantly for 2012. Eight new codes were added (CPT codes 15271–15278) in the integumentary section under the subsection “Skin Substitutes Grafts” to replace 32 deleted codes (15170–15431) that defined the specific type of skin substitute.

Skin substitute grafts are used as temporary closure for wounds of the trunk, arms, or legs. A graft functions as a short-term measure to close wounds and provide a barrier against infection and fluid loss, reduce pain, and promote healing of underlying tissues until a permanent graft can be applied. Common skin substitutes are acellular dermal replacement, temporary allograft, acellular dermal allograft, tissue-cultured allogeneic skin substitute, and xenografts. The graft procedures are reported according to graft size and location of the defect (recipient site).

The coding guidelines indicate that these services include preparation of the defect and application of skin or skin replacement. These procedures do not include the application of injected skin substitutes or non-graft wound dressings. Removal of the current graft is included, if applicable. Debridement is reported separately only when it is used to remove significant amounts of devitalized skin or the wound is grossly contaminated and requires prolonged cleansing.

For multiple wounds of the same anatomical area, the surface areas are added together. If there are multiple wounds of different anatomical areas, the anatomical areas that are grouped together are added together and multiple codes within code range 15271–15278 are reported. Modifier 59 (Distinct procedural service) is appended to each subsequent code after the primary procedure. Supplies used when providing this procedure may be reported with the appropriate HCPCS Level II Q code. For this section of codes, the supply of the skin substitute is reported separately

Coders are advised to read the code descriptions carefully as the codes are not in uniform units. The codes are selected by the anatomical location and the area of the defect. Note: the first code of each family (15271, 15273, 15275, and 15277) is for the first 25 square centimeters, 100 square centimeters of wounds, or 1 percent of body area of infants and children up to 100 square centimeters. The second code (15272, 15274, 15276, and 15278) in each family is an add-on code identifying each additional 25 square centimeters, each additional 100 square centimeters, or 1 percent of body area for infants or children. The add-on codes should be used in addition to the code for the primary procedure.

 

 
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