Skin Replacement Surgery

 

 

Skin replacement surgery consists of surgical preparation and topical placement of an autograft (including tissue cultured autograft) or skin substitute graft (ie, homograft, allograft, xenograft). The graft is anchored using the individual’s choice of fixation. When services are performed in the office, routine dressing supplies are not reported separately.

The following definition should be applied to those codes that reference “100 sq cm or 1% of body area of infants and children” when determining the involvement of body size: The measurement of 100 sq cm applies to adults and children 10 years of age and older, and percentages of body surface area apply to infants and children younger than 10 years of age. The measurements apply to the size of the recipient area. Procedures involving the wrist and/or ankle are reported with codes that include arm or leg in the descriptor.

When a primary procedure requires a skin substitute or skin autograft for definitive skin closure (eg, orbit ectomy, radical mastectomy, deep tumor removal), use 15100-15278 in conjunction with the primary procedure.

 

For biological implants for soft tissue reinforcement, use 15777 in conjunction with the primary procedure.
The supply of skin substitute graft(s) should be reported separately in conjunction with 15271-15278.

Definitions

Surgical preparation codes 15002-15005 for skin replacement surgery describe the initial services related to preparing a clean and viable wound surface for placement of an autograft, flap, skin substitute graft, or negative pressure wound therapy. In some cases, closure may be possible using adjacent tissue transfer (14000-14061) or complex repair (13100-13153). In all cases, appreciable nonviable tissue is removed to treat a burn, traumatic wound, or a necrotizing infection. The clean wound bed may also be created by incisional release of a scar contracture resulting in a surface defect from the separation of tissues.

 

The intent is to heal the wound by primary intention, or by the use of negative pressure wound therapy. Patient conditions may require the closure or application of graft, flap, or skin substitute to be delayed, but in all cases, the intent is to include these treatments or negative pressure wound therapy to heal the wound. Do not report 15002-15005 for removal of nonviable tissue/debris in a chronic wound (eg, venous or diabetic) when the wound is left to heal by secondary intention. See active wound management codes (97597, 97598) and debridement codes (11042-11047) for this service. For necrotizing soft tissue infections in specific anatomic locations, see 11004-11008.

Select the appropriate code from 15002-15005 based on the location and size of the resultant defect. For multiple wounds, sum the surface area of all wounds from all anatomic sites that are grouped into the same code descriptor. For example, sum the surface area of all wounds on the trunk and arms. Do not sum wounds from different groupings of anatomic sites (eg, face and arms). Use 15002 or 15004, as appropriate, for excisions and incisional releases resulting in wounds up to and including 100 sq cm of surface area. Use 15003 or 15005 for each additional 100 sq cm or part thereof. For example: Surgical preparation of a 20 sq cm wound on the right hand and a 15 sq cm wound on the left hand would be reported with a single code, 15004. Surgical preparation of a 75 sq cm wound on the right thigh and a 75 sq cm wound on the left thigh would be reported with 15002 for the first 100 sq cm and 15003 for the second 50 sq cm. If all four wounds required surgical preparation on the same day, use modifier 59 with 15002, and 15004.
Autografts/tissue-cultured autografts include the harvest and/or application of an autologous skin graft. Repair of donor sites requiring skin graft or local flaps is reported separately.

Removal of the current graft and/or simple cleansing of the wound is included when performed. Do not report 97602. Debridement is considered a separate procedure only when gross contamination requires prolonged cleansing when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure.

Select the appropriate code from 15040-15261 based on the type of autograft and the location and size of the defect. The measurements apply to the size of the recipient area. For multiple wounds, sum the surface area of all wounds from all anatomic sites that are grouped into the same code descriptor. For example, sum the surface area of all wounds on the trunk and arms. Do not sum wounds from different groupings of anatomic sites (eg, face and arms).
Skin substitute grafts include non-autologous human skin (dermal or epidermal, cellular and acellular) grafts (eg, homograft, allograft), non-human skin substitute grafts (ie, xenograft), and biological products that form a sheet scaffolding for skin growth. These codes are not to be reported for the application of non-graft wound dressings (eg, gel, powder, ointment, foam, liquid) or injected skin substitutes. Application of non-graft wound dressings is not separately reportable.

Removal of the current graft and/or simple cleansing of the wound is included when performed. Do not report 97602. Debridement is considered a separate procedure only when gross contamination requires prolonged cleansing when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure.
Select the appropriate code from 15271-15278 based on the location and size of the defect. For multiple wounds, sum the surface area of all wounds from all anatomic sites that are grouped into the same code descriptor. For example, sum the surface area of all wounds on the trunk and arms. Do not sum wounds from different groupings of anatomic sites (eg, face and arms). The supply of skin substitute graft(s) should be reported separately in conjunction with 15271, 15272, 15273, 15274, 15275, 15276, 15277, and 15278. For biologic implants for soft tissue reinforcement, use 15777 in conjunction with code for primary procedure.

 

Surgical Preparation

CPT CODE- 15002 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children (For linear scar revision, see 13100-13153)

1. • CPT code 15002 is used for surgical preparation or creation of a recipient site.
   • This procedure involves the excision of open wounds, burn eschar, or scars, including subcutaneous tissues.
   • It also includes incisional release of scar contracture on the trunk, arms, or legs.
   • The code specifically applies to the first 100 sq cm or 1% of the body area in infants and children.
2. Exclusion Criteria:
   • For linear scar revision, refer to codes 13100-13153.
3. Body Area Calculation:
   • Calculate the area based on the extent of the wounds, burn eschar or scar excised, including subcutaneous tissues.
   • The first 100 sq cm or 1% of the body area of infants and children is covered by this code.
4. Documentation Requirements:
   • Adequate documentation must be provided to support the medical necessity of the procedure.
   • Include details about the size of the excised area, the nature of the wound or scar, and any complications if present.
5. Age Criteria:
   • This code is specifically designed for infants and children.

Example:

Scenario: A 3-year-old child presents with a burn scar on the left arm measuring 80 sq cm. The surgeon performs surgical preparation and excision of the scar.

Code Assignment:

• CPT Code: 15002
• Description: Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the scar: 80 sq cm
• Location: Left arm
• Nature of the scar: Burn scar
• Patient’s age: 3 years

By following these guidelines and providing accurate documentation, you ensure proper coding for the surgical procedure described by CPT code 15002

 

CPT CODE – ✚ 15003  Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs;  each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children
(List separately in addition to code for primary procedure)
(Use 15003 in conjunction with 15002)

CPT CODE – 15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children

 

1. CPT code 15004 is used for surgical preparation or the creation of a recipient site.

1. • This procedure involves the excision of open wounds, burn eschar, or scar, including subcutaneous tissues.
   • It also includes the incisional release of scar contracture on specific areas: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
   • The code specifically applies to the first 100 sq cm or 1% of the body area in infants and children.
2. Body Area Calculation:
   • Calculate the area based on the extent of the wounds, burn eschar or scar excised, including subcutaneous tissues.
   • The first 100 sq cm or 1% of the body area of infants and children is covered by this code.
3. Documentation Requirements:
   • Adequate documentation must be provided to support the medical necessity of the procedure.
   • Include details about the size of the excised area, the nature of the wound or scar, and any complications if present.
   • Specify the anatomical location (e.g., face, scalp, eyelids) where the procedure is performed.
4. Age Criteria:
   • This code is specifically designed for infants and children.

Example:

Scenario: A 5-year-old child presents with a burn scar on the face measuring 90 sq cm. The surgeon performs surgical preparation and excision of the scar.

Code Assignment:

• CPT Code: 15004
• Description: Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the scar: 90 sq cm
• Location: Face
• Nature of the scar: Burn scar
• Patient’s age: 5 years

By adhering to these guidelines and providing accurate documentation, you ensure proper coding for the surgical procedure described by CPT code 15004

 

CPT CODE – ✚ 15005  Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children. (List separately in addition to code for primary procedure)
(Use 15005 in conjunction with 15004)

 

Autografts/Tissue Cultured Autograft

 

CPT CODE – 15040 Harvest of skin for tissue cultured skin autograft, 100 sq cm or less

 

CPT CODE – 15050 Pinch graft, single or multiple, to cover small ulcer, the tip of the digit, or another minimal open area (except on face), up to defect size 2 cm diameter

 

CPT CODE – 15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children(except 15050)

 

1. CPT code 15100 is used for a split-thickness autograft procedure.
   • The procedure involves the application of a split-thickness autograft to the trunk, arms, or legs.
   • The code is applicable for the first 100 sq cm or less, or 1% of the body area in infants and children.

 

2. Size Limitation:

• • • This code is used when the area to be grafted is 100 sq cm or less or 1% of the body area in infants and children.

 

3. Body Area Calculation:

• • • • Calculate the area based on the extent of the graft on the trunk, arms, or legs.
      • Ensure compliance with the specified size limitation.

4. Age Criteria:

This code is specifically designed for infants and children.

5. Documentation Requirements:

• • Adequate documentation is crucial to support the medical necessity of the procedure.
  • Include details about the size of the graft, the specific location on the trunk, arms, or legs, and any specific conditions or complications.

Example:

Scenario: A 7-year-old child sustains a burn injury on the leg, requiring a split-thickness autograft. The graft size is 80 sq cm.

Code Assignment:

• CPT Code: 15100
• Description: Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the autograft: 80 sq cm
• Location: Leg
• Patient’s age: 7 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the split-thickness autograft procedure described by CPT code 15100.

 

CPT CODE ✚ 15101 Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
(Use 15101 in conjunction with 15100

 

CPT CODE – 15110 Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

 

CPT code 15110 is used for an epidermal autograft procedure.

The procedure involves the application of an epidermal autograft to the trunk, arms, or legs.

The code is applicable for the first 100 sq cm or less, or 1% of the body area in infants and children.

1. Size Limitation:
   • This code is used when the area to be grafted is 100 sq cm or less or 1% of the body area in infants and children.
2. Body Area Calculation:
   • Calculate the area based on the extent of the graft on the trunk, arms, or legs.
   • Ensure compliance with the specified size limitation.
3. Age Criteria:
   • This code is specifically designed for infants and children.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the autograft, the specific location on the trunk, arms, or legs, and any specific conditions or complications.

Example:

Scenario: A 5-year-old child experiences a traumatic injury on the arm requiring an epidermal autograft. The graft size is 90 sq cm.

Code Assignment:

• CPT Code: 15110
• Description: Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the autograft: 90 sq cm
• Location: Arm
• Patient’s age: 5 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the epidermal autograft procedure described by CPT code 15110.

 

 

CPT CODE – ✚ 15111 Epidermal autograft, trunk, arms, legs;  each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
(Use 15111 in conjunction with 15110)

 

CPT CODE – 15115 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

1. • CPT code 15115 is used for an epidermal autograft procedure.
   • The procedure involves the application of an epidermal autograft to specific areas: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
   • The code is applicable for the first 100 sq cm or less, or 1% of the body area in infants and children.
2. Size Limitation:
   • This code is used when the area to be grafted is 100 sq cm or less or 1% of the body area in infants and children.
3. Body Area Calculation:
   • Calculate the area based on the extent of the graft on the specified areas.
   • Ensure compliance with the specified size limitation.
4. Age Criteria:
   • This code is specifically designed for infants and children.
5. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the autograft, the specific location on the face, scalp, eyelids, etc., and any specific conditions or complications.

Example:

Scenario: A 9-year-old child sustains a burn injury on the face requiring an epidermal autograft. The graft size is 80 sq cm.

Code Assignment:

• CPT Code: 15115
• Description: Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the autograft: 80 sq cm
• Location: Face
• Patient’s age: 9 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the epidermal autograft procedure described by CPT code 15115.

 

 

CPT CODE – ✚ 15116  Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
(Use 15116 in conjunction with 15115)

 

CPT CODE- 15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)

1. • CPT code 15120 is used for a split-thickness autograft procedure.
   • The procedure involves the application of a split-thickness autograft to specific areas: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
   • The code is applicable for the first 100 sq cm or less, or 1% of the body area in infants and children.
2. Size Limitation:
   • This code is used when the area to be grafted is 100 sq cm or less or 1% of the body area in infants and children.
3. Body Area Calculation:
   • Calculate the area based on the extent of the graft on the specified areas.
   • Ensure compliance with the specified size limitation.
4. Age Criteria:
   • This code is specifically designed for infants and children.
5. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the autograft, the specific location on the face, scalp, eyelids, etc., and any specific conditions or complications.

Example:

Scenario: A 6-year-old child sustains a burn injury on the hand requiring a split-thickness autograft. The graft size is 90 sq cm.

Code Assignment:

• CPT Code: 15120
• Description: Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of the body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the autograft: 90 sq cm
• Location: Hand
• Patient’s age: 6 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the split-thickness autograft procedure described by CPT code 15120.

CPT CODE – ✚ 15121 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure). (Use 15121 in conjunction with 15120) (For eyelids, see also 67961-67975)

 

CPT CODE- 15130 Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

1. • CPT code 15130 is used for a dermal autograft procedure.
   • The procedure involves the application of a dermal autograft to the trunk, arms, or legs.
   • The code is applicable for the first 100 sq cm or less, or 1% of the body area in infants and children.
2. Size Limitation:
   • This code is used when the area to be grafted is 100 sq cm or less or 1% of the body area in infants and children.
3. Body Area Calculation:
   • Calculate the area based on the extent of the graft on the trunk, arms, or legs.
   • Ensure compliance with the specified size limitation.
4. Age Criteria:
   • This code is specifically designed for infants and children.
5. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the autograft, the specific location on the trunk, arms, or legs, and any specific conditions or complications.

Example:

Scenario: An 8-year-old child presents with a traumatic injury on the leg requiring a dermal autograft. The graft size is 80 sq cm.

Code Assignment:

• CPT Code: 15130
• Description: Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the autograft: 80 sq cm
• Location: Leg
• Patient’s age: 8 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the dermal autograft procedure described by CPT code 15130.

 

CPT CODE – ✚ 15131 Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
(Use 15131 in conjunction with 15130)

CPT CODE – 15135 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

1. • CPT code 15135 is used for a dermal autograft procedure.
   • The procedure involves the application of a dermal autograft to specific areas: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
   • The code is applicable for the first 100 sq cm or less, or 1% of the body area in infants and children.
2. Size Limitation:
   • This code is used when the area to be grafted is 100 sq cm or less or 1% of the body area in infants and children.
3. Body Area Calculation:
   • Calculate the area based on the extent of the graft in the specified areas.
   • Ensure compliance with the specified size limitation.
4. Age Criteria:
   • This code is specifically designed for infants and children.
5. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the autograft, the specific location on the face, scalp, eyelids, etc., and any specific conditions or complications.

Example:

Scenario: A 10-year-old child sustains a burn injury on the hand requiring a dermal autograft. The graft size is 90 sq cm.

Code Assignment:

• CPT Code: 15135
• Description: Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Size of the autograft: 90 sq cm
• Location: Hand
• Patient’s age: 10 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the dermal autograft procedure described by CPT code 15135.

CPT CODE – ✚ 15136 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits  each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
(Use 15136 in conjunction with 15135)

CPT CODE- 15150 Tissue cultured skin autograft, trunk, arms, legs; first 25sq cm or less

1. • CPT code 15150 is used for a tissue-cultured skin autograft procedure.
   • The procedure involves the application of tissue-cultured skin autograft to the trunk, arms, or legs.
   • The code is applicable for the first 25 sq cm or less.
2. Size Limitation:
   • This code is used when the area to be grafted is 25 sq cm or less.
3. Body Area Calculation:
   • Calculate the area based on the extent of the graft on the trunk, arms, or legs.
   • Ensure compliance with the specified size limitation.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the autograft, the specific location on the trunk, arms, or legs, and any specific conditions or complications.

Example:

Scenario: A patient undergoes a tissue-cultured skin autograft on the arm due to severe abrasion, and the graft size is 20 sq cm.

Code Assignment:

• CPT Code: 15150
• Description: Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less.

Documentation: The medical record should include the following information:

• Size of the autograft: 20 sq cm
• Location: Arm
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the tissue-cultured skin autograft procedure described by CPT code 15150.

 

CPT CODE -✚ 15151 Tissue cultured skin autograft, trunk, arms, legs additional 1 sq cm to 75 sq cm (List separately in addition to code for primary procedure) (Do not report 15151 more than once per session) (Use 15151 in conjunction with 15150)

CPT CODE- ✚ 15152Tissue cultured skin autograft, trunk, arms, legs  each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) (Use 15152 in conjunction with 15151)

CPT CODE- 15155 Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less

1. • CPT code 15155 is used for a tissue-cultured skin autograft procedure.
   • The procedure involves the application of tissue-cultured skin autograft to specific areas: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
   • The code is applicable for the first 25 sq cm or less.
2. Size Limitation:
   • This code is used when the area to be grafted is 25 sq cm or less.
3. Body Area Calculation:
   • Calculate the area based on the extent of the graft in the specified areas.
   • Ensure compliance with the specified size limitation.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the autograft, the specific location on the face, scalp, eyelids, etc., and any specific conditions or complications.

Example:

Scenario: A patient undergoes a tissue-cultured skin autograft on the hand due to a traumatic injury, and the graft size is 15 sq cm.

Code Assignment:

• CPT Code: 15155
• Description: Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less.

Documentation: The medical record should include the following information:

• Size of the autograft: 15 sq cm
• Location: Hand
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the tissue-cultured skin autograft procedure described by CPT code 15155.

CPT CODE – ✚ 15156  Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (List separately in addition to code for primary procedure) (Do not report 15156 more than once per session) (Use 15156 in conjunction with 15155)

CPT CODE – ✚ 15157 Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
(Use 15157 in conjunction with 15156)

 

CPT CODE- 15200 Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less

1. • CPT code 15200 is used for a full-thickness graft procedure.
   • The procedure involves the application of a free full-thickness graft to the trunk.
   • This code is applicable for grafts of 20 sq cm or less.
2. Size Limitation:
   • This code is used when the area to be grafted is 20 sq cm or less.
3. Body Area Calculation:
   • Calculate the area based on the extent of the full-thickness graft on the trunk.
   • Ensure compliance with the specified size limitation.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the graft, the specific location on the trunk, and any specific conditions or complications.

Example:

Scenario: A patient requires a full-thickness graft on the back due to surgical excision of a lesion, and the graft size is 18 sq cm.

Code Assignment:

• CPT Code: 15200
• Description: Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less.

Documentation: The medical record should include the following information:

• Size of the graft: 18 sq cm
• Location: Trunk (Back)
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the full-thickness graft procedure described by CPT code 15200.

CPT CODE-  ✚ 15201 Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) (Use 15201 in conjunction with 15200)

 

CPT CODE- 15220 Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less

 

1. CPT code 15220 is used for a full-thickness graft procedure.

           The procedure involves the application of a free full-thickness graft to the scalp, arms, and/or legs.

            This code is applicable for grafts of 20 sq cm or less.

2. Size Limitation:

• • This code is used when the area to be grafted is 20 sq cm or less.

 

3. Body Area Calculation:

• • • Calculate the area based on the extent of the full-thickness graft on the specified areas (scalp, arms, and/or legs).
    • Ensure compliance with the specified size limitation.

 

4. Documentation Requirements:

• • • • Adequate documentation is crucial to support the medical necessity of the procedure.
      • Include details about the size of the graft, the specific location on the scalp, arms, and/or legs, and any specific conditions or complications.

Example:

Scenario: A patient undergoes a full-thickness graft on the arm due to a traumatic injury, and the graft size is 15 sq cm.

Code Assignment:

• CPT Code: 15220
• Description: Full-thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less.

Documentation: The medical record should include the following information:

• Size of the graft: 15 sq cm
• Location: Arm
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the full-thickness graft procedure described by CPT code 15220.

CPT CODE- ✚ 15221 Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs  each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) (Use 15221 in conjunction with 15220)

 

CPT CODE – 15240 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less

(For fingertip graft, use 15050)
(For repair of syndactyly, fingers, see 26560-26562)

1. • CPT code 15240 is used for a full-thickness graft procedure.
   • The procedure involves the application of a free full-thickness graft to specific areas: forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet.
   • This code is applicable for grafts of 20 sq cm or less.
2. Size Limitation:
   • This code is used when the area to be grafted is 20 sq cm or less.
3. Body Area Calculation:
   • Calculate the area based on the extent of the full-thickness graft on the specified areas.
   • Ensure compliance with the specified size limitation.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the graft, the specific location on the forehead, cheeks, chin, etc., and any specific conditions or complications.

Example:

Scenario: A patient undergoes a full-thickness graft on the chin due to a traumatic injury, and the graft size is 18 sq cm.

Code Assignment:

• CPT Code: 15240
• Description: Full-thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less.

Documentation: The medical record should include the following information:

• Size of the graft: 18 sq cm
• Location: Chin
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the full-thickness graft procedure described by CPT code 15240.

 

CPT CODE- ✚ 15241 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
(Use 15241 in conjunction with 15240)

 

CPT CODE- 15260 Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less

 

1. • CPT code 15260 is used for a full-thickness graft procedure.
   • The procedure involves the application of a free full-thickness graft to specific areas: nose, ears, eyelids, and/or lips.
   • This code is applicable for grafts of 20 sq cm or less.
2. Size Limitation:
   • This code is used when the area to be grafted is 20 sq cm or less.
3. Body Area Calculation:
   • Calculate the area based on the extent of the full-thickness graft on the specified areas.
   • Ensure compliance with the specified size limitation.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the size of the graft, the specific location on the nose, ears, eyelids, and lips, and any specific conditions or complications.

Example:

Scenario: A patient undergoes a full-thickness graft on the nose due to a reconstructive procedure, and the graft size is 16 sq cm.

Code Assignment:

• CPT Code: 15260
• Description: Full-thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less.

Documentation: The medical record should include the following information:

• Size of the graft: 16 sq cm
• Location: Nose
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the full-thickness graft procedure described by CPT code 15260.

CPT CODE- ✚ 15261 Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) (Use 15261 in conjunction with 15260)
(For eyelids, see also 67961-67975)
(Repair of donor site requiring skin graft or local flaps is considered a separate procedure)

 

Skin Substitute Grafts

 

The supply of skin substitute graft(s) should be reported separately in conjunction with 15271-15278. For biologic implants for soft tissue reinforcement, use 15777 in conjunction with code for primary procedure.

CPT CODE- 15271 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

1. • CPT code 15271 is used for the application of a skin substitute graft to the trunk, arms, or legs.
   • The code is applicable for the total wound surface area up to 100 sq cm.
   • Specifically, this code covers the first 25 sq cm or less of the wound surface area.
2. Size Limitation:
   • This code is used when the total wound surface area is up to 100 sq cm.
   • It specifically covers the first 25 sq cm or less of the wound.
3. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the total wound surface area, the specific location on the trunk, arms, or legs, and any specific conditions or complications.

Example:

Scenario: A patient has a wound on the leg requiring the application of a skin substitute graft, and the total wound surface area is 20 sq cm.

Code Assignment:

• CPT Code: 15271
• Description: Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area.

Documentation: The medical record should include the following information:

• Total wound surface area: 20 sq cm
• Location: Leg
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the application of a skin substitute graft procedure described by CPT code 15271.

✚ 15272 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)
(Use 15272 in conjunction with 15271)
(For total wound surface area greater than or equal to 100 sq cm, see 15273, 15274)
(Do not report 15271, 15272 in conjunction with 15273, 15274)

 

 

CPT CODE- 15273 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

 

1. • CPT code 15273 is used for the application of a skin substitute graft to the trunk, arms, or legs.
   • The code is applicable when the total wound surface area is greater than or equal to 100 sq cm.
   • Specifically, this code covers the first 100 sq cm wound surface area or 1% of the body area of infants and children.
2. Size Limitation:
   • This code is used when the total wound surface area is greater than or equal to 100 sq cm.
   • It specifically covers the first 100 sq cm wound surface area or 1% of the body area of infants and children.
3. Age Criteria:
   • This code specifies that it applies to infants and children.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the total wound surface area, the specific location on the trunk, arms, or legs, and any specific conditions or complications.

Example:

Scenario: A 5-year-old child has a large wound on the arm requiring the application of a skin substitute graft, and the total wound surface area is 120 sq cm.

Code Assignment:

• CPT Code: 15273
• Description: Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Total wound surface area: 120 sq cm
• Location: Arm
• Patient’s age: 5 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the application of a skin substitute graft procedure described by CPT code 15273

 

CPT CODE- ✚ 15274 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) (Use 15274 in conjunction with 15273)
(For total wound surface area up to 100 sq cm, see 15271, 15272)

 

CPT CODE- 15275 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

 

1. • CPT code 15275 is used for the application of a skin substitute graft to specific areas: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
   • The code is applicable for a total wound surface area up to 100 sq cm.
   • Specifically, it covers the first 25 sq cm or less of the wound surface area.
2. Size Limitation:
   • This code is used when the total wound surface area is up to 100 sq cm.
   • It specifically covers the first 25 sq cm or less of the wound surface area.
3. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the total wound surface area, the specific location on the face, scalp, eyelids, etc., and any specific conditions or complications.

Example:

Scenario: A patient has a wound on the hand requiring the application of a skin substitute graft, and the total wound surface area is 20 sq cm.

Code Assignment:

• CPT Code: 15275
• Description: Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area.

Documentation: The medical record should include the following information:

• Total wound surface area: 20 sq cm
• Location: Hand
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the application of a skin substitute graft procedure described by CPT code 15275.

 

CPT CODE- ✚ 15276 each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)
(Use 15276 in conjunction with 15275)
(For total wound surface area greater than or equal to 100 sq cm, see 15277, 15278)
(Do not report 15275, 15276 in conjunction with 15277, 15278)

 

CPT CODE- 15277 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

 

1. • CPT code 15277 is used for the application of a skin substitute graft to specific areas: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
   • The code is applicable for a total wound surface area greater than or equal to 100 sq cm.
   • Specifically, it covers the first 100 sq cm wound surface area or 1% of the body area of infants and children.
2. Size Limitation:
   • This code is used when the total wound surface area is greater than or equal to 100 sq cm.
   • It specifically covers the first 100 sq cm wound surface area or 1% of the body area of infants and children.
3. Age Criteria:
   • This code specifies that it applies to infants and children.
4. Documentation Requirements:
   • Adequate documentation is crucial to support the medical necessity of the procedure.
   • Include details about the total wound surface area, the specific location on the face, scalp, eyelids, etc., and any specific conditions or complications.

Example:

Scenario: A 7-year-old child has a significant burn injury on the face requiring the application of a skin substitute graft, and the total wound surface area is 120 sq cm.

Code Assignment:

• CPT Code: 15277
• Description: Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children.

Documentation: The medical record should include the following information:

• Total wound surface area: 120 sq cm
• Location: Face
• Patient’s age: 7 years
• Any specific conditions or complications

By following these guidelines and providing accurate documentation, you ensure proper coding for the application of a skin substitute graft procedure described by CPT code 15277.

 

CPT CODE- ✚ 15278 each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
(Use 15278 in conjunction with 15277)
(For total wound surface area up to 100 sq cm, see 15275, 15276)
(Do not report 15271-15278 in conjunction with 97602)

 

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