Part B Insider (Multispecialty) Coding Alert

Published on Sun Apr 09, 2006 PDF

Learn which common podiatry products line up with new skin graft codes

Hot on the heels of newly emerging skin graft technology, CPT made a bold move that expanded your coding choices and opened the door for more podiatry materials to move to acellular xenograft status.

CPT doubled its skin graft options from 21 to 54 codes under the new category “Skin Replacement Surgery and Skin Substitutes.”
Reason: A lot of the old codes just didn’t apply,” especially for wound care, says Linda Gracey, CPC, coder and medical billing supervisor for the dermatology department at Johns Hopkins University School of Medicine in Baltimore.

Here are four key additions:

• 15340--Tissue cultured allogeneic skin substitute; first 25 sq cm or less

• +15341--… each additional 25 sq cm

• 15430--Acellular xenograft implant; first 100 sq cm or less, or one percent of body area of infants and children

• +15431--… each additional 100 sq cm, or each additional one percent of body area of infants and children, or part thereof.

Codes 15340-15341 replaced the old codes for skin substitutes 15342-15343 (Application of bilaminate skin substitute/neodermis...). You should be using the new codes to report grafts with products like Apligraf or Dermagraft.

Tricky: The addition of 15430 raises the question whether an acellular collagen matrix, such as Oasis, falls into the acellular xenograft category. Podiatrists often use Oasis, a matrix derived from porcine submucosal tissue, to treat ulcers for diabetic patients. In the past, Medicare carriers have hammered home that this product should be considered a “wound care dressing” and not a xenograft.

Rest assured: While Medicare has not yet published an official determination on the status of products like Oasis with CPT Codes 2006, several experts have confirmed that they will advance to acellular xenograft status with the addition of 15430.

“We worked a lot with podiatrists on the addition of code 15430, and it is appropriate for use with acellular xenograft products, including Oasis,” says Kitty Vineyard, MA, director of the American Burn Association in Chicago.