CPT 2006 Shows More Skin--And Your Practice Will Benefit
Published on Thu Jan 19, 2006
You'll have to differentiate between layers of skin when applying graft codes
With a host of new and revised codes for 2006, CPT gives you the specificity you need--and, hopefully, the reimbursement you deserve--for a variety of skin grafting techniques.
The overview: CPT has renamed the -Free Skin Grafts- subsection -Skin Replacement Surgery and Skin Substitutes.- This portion of CPT adds 37 brand-new codes, revises five codes and deletes four codes, and now includes a total of 54 codes (up from just 21 in 2005).
The advantages: Many of the new codes seem designed to represent some new techniques and procedures, says Teresa Thompson, CPC, CCC, with TM Consulting in Sequim, Wash. They include new codes for autografts (15100-15157), acellular dermal replacements (15170-15176), allografts (15300-15336), skin substitutes (15340-15366) and xenografts (15400-15431). Many of the codes are specific to particular products or technologies. Describe Depth With New Codes The expansion of the skin graft CPT codes allows you to specify the depth of the graft and/or the graft material the surgeon uses. The range of codes for autologous (autogenous) skin grafts (15100-15261), for instance, now includes codes for:
- split thickness autografts--15100-15101 and 15120-15121
- epidermal autografts--15110-15116
- dermal autografts--15130-15136
- tissue cultured epidermal autograft--15150-15157
- acellular dermal replacements (also called neodermis, skin substitute, AlloDerm or Dermagraft)--15170-15176. Until now, you probably struggled to get paid for some of these expensive and specialized products using a general skin graft code, says John Bishop, PA-C, CPC, president of Bishop & Associates in Tampa, Fla. -Because an ENT can basically function as a facial plastic surgeon, any of the new skin codes that apply to the areas of face and neck are of interest for otolaryngology practices,- says Barbara J. Cobuzzi, MBA, CPC, CPC-H, CHBME, president of CRN Healthcare Solutions, a coding and reimbursement consulting firm in Shrewsbury, N.J.
Harvest a Code for Harvesting Cultured Autograft You may now report harvesting of keratinocytes and dermal tissue for tissue-cultured skin grafts separately, when performed. The new code for harvesting cultured skin autografts is 15040 (Harvest of skin for tissue cultured skin autograft, 100 sq cm or less).
In the past, you could only report cultured skin graft harvests separately by reporting a biopsy code, which really didn't describe the procedure properly. As a result, many payers wouldn't reimburse the procedure separately, says John Bishop, PA-C, CPC, president of Bishop & Associates in Tampa, Fla.
Surface Area and Location Matter Almost all of the new codes for special grafts specify a primary code for grafts of 100 cm or less and an add-on code for each additional 100 cm. Generally, one pair of codes describes grafts for trunk, arms and legs, with a second pair of codes (which would be more useful for ENTs) for [...]
