Wiki Apligraf placement

mbarker

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If the doctor does not suture the Apligraf but applies a wrap to hold the graft in place can you still code out a 15340 for the placement?
 
Hi there,

I code wound care for our OP clinic. I have never seen documentation for Oasis, dermagraft or Apligraf with a wrap instead of sutures. Here is an excerpt from the LCD from Noridian, "For coverage of skin substitute products (devices) subject to Noridians Application of Skin Substitutes LCD, a product will be considered as a graft if the product is intended:
1) at the time of application to fully replace lost tissue, and

2) to achieve closure of a wound (whether in fact it is successful is not a firm criterion upon which payment would be based)

The expectation is that the product itself will function as a permanent replacement for the lost or damaged skin.

On the other hand, if the product is intended to achieve temporary closure or coverage of the wound, or to act as a matrix or scaffolding that encourages and/or otherwise supports the ingrowth of the patients own tissues in order to achieve permanent wound closure, we will not consider that use as a graft. Application of products, which warrant routine and/or anticipated replacement would be - at best - wound dressings, not grafts."

The LCD number is L24273 if you want to check it out for yourself.

I would want to make sure there is documentation as to why there are no sutures being used for the graft.

Hope this helps you,
 
The CPT guidelines for Surgery/Integumentary System says " The codes are not intended to be reported for simple graft application alone or application stabilized with dressings (eg, by simple guze wrap)"
 
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