Skin Sub +15777
Good morning!
This code was developed by the Plastics specialty society to help define the evolving use of a variety of skin substitute (dermal and amniotic) and biologics that are used as fully implantable products to support a soft tissue repair, defect, or scaffolding.
However, the American College of Surgeons also anticipates that this code will be used to report unusual abdominal procedures (i.e. tumor removal where there's a specific defect that needs to be "filled").
In review of the codes you mention, 35556 is already a "graft" procedure. So if +15777 is to be applicable, it would need to be a separate anatomical site. Also, +35700 is already an Add-on code, and 11043 is a debridement service. I agree with the payor in that there is not a "base code" here to append +15777.
The only thing I would mention is that if the service was furnished in an office or you are responsible for reporting the facility component, I would remind you to report the skin substitute product itself (Q41**). These HCPCS are reported per sq cm, units EXPOSED (not implanted) in the operating room. Clearly, the provider is responsible for using the most appropriate available size so as to minimize waste.
Thank you, I hope you found this information helpful. Good luck.
Mary Corkins
TRG
maryc@trgltd.com