Wiki Can you please explain to me

[Joy Amargo]

Can you please explain to me.. How could we add the x7 or x16 please read the question and the answer is letter C but im still confuse how do i count the time. .. and how is it become x7 on base of location followed by x16 when it comes to 15400:::::: im so confused:....
A 15-year-old boy was burned in a fire and assessed to have received burns to 75 percent of his total body surface area. He was transferred to a burn center for definitive treatment. Once stable, he was brought to the OR. Procedure: Due to extent of the patient's burns and lack of sufficient donor sites, his full-thickness burns will be excised and covered with porcine grafts, and a split-thickness skin biopsy will be harvested for preparation of autologous grafts to be applied in the coming weeks, when available. After induction of anesthesia, extensive debridement of the full-thickness burns was undertaken. Attention was first directed to the patient's face, neck, and scalp. A total of 500 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved using electrocautery. Attention was then turned to the trunk. A total of 950 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved. Attention was then turned to the arms and legs. A total of 725 sq cm received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved. Attention was then turned to the hands and feet. A total of 300 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. All involved areas were then covered with porcine graft. Finally a split thickness skin graft of 0.015 inches in depth was harvested using a dermatome from a separate donor site. A total of 85 sq cm was recovered. What procedures codes would be reported service?
A. 15300, 15301 x 10, 15320, 15321 x 10, 15004, 15005, 15002, 15003

B. 15420, 15421 x 7, 15400, 15401 x 16, 15004, 15005 x 16, 15002, 15003 x 7

C. 15420, 15421 x 7, 15400, 15401 x 16, 15004, 15005 x 7, 15002, 15003 x 16, 15040

D. 15420, 15421 x 7, 15400, 15401 x 16, 15004, 15005 x 7, 15002, 15003 x 16

 

[FTessaBartels]

Counting sq cm

You are not counting time, you are adding up square centimeters.
I'll take just the first two codes to explain the principle.

15420 Xenograft ... face, scalp, neck, hands, feet ... FIRST 100 sq cm
15421 Xenograft ... EACH additional 100 sq cm ... or part thereof)

The op note tell us that there were 500 sq cm of graft to the face, scalp and neck. Later on in the note we learn that there were 300 sq cm of graft to the hands and feet. All these are part of the same code set - 15420 / 15421. So you add 500 sq cm plus 300 sq cm and get a total of 800 sq cm in the face, scalp, neck, hands and feet.

The first 100 sq cm is coded using 15420. (That's easy enough).
The next 700 sq cm is coded using 15421 for EACH additional 100 sq cm. Since you have 700 sq cm you code 15421 x 7.

You take the same approach with the 15400, 15401 set, though here you are looking at the trunk, arms and legs (except not the hands and feet). Here your total from the op note is 1675 sq cm (950 sq cm on trunk plus 725 sq cm on the legs and arms). The first 100 sq cm is coded using 15400. The remaining 1575 is coded using 15401 x 16 (16 because it is 100 sq or part thereof)

Hope that helps.

F Tessa Bartels, CPC, CEMC