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add on code 15777

  1. #1
    Default add on code 15777
    Exam Training Packages
    can somebody advise if is there any proper list of primary codes for 15777? we are cluless in terms of this.
    please help!!

  2. #2
    Default Bonnie Smallidge CPC
    I found this information online and am not sure if it is helpful or not, but am thinking that it may at least give you somewhere to start at this point?:

    Rationale

    A new add-on code 15777 has been established to report the implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (eg, breast, trunk) in addition to the primary procedure.

    This is in contrast to codes 15271-15278, which are intended for reporting topical application of skin substitute graft

  3. #3
    Location
    Jamaica, NY
    Posts
    28
    Default
    According to EncoderPro you must code the primary procedure first:

    15002 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children
    15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children
    15040 Harvest of skin for tissue cultured skin autograft, 100 sq cm or less
    15050 Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter
    15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
    15110 Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
    15115 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children
    15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
    15130 Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
    15135 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children
    15150 Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less
    15155 Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less
    15200 Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less
    15220 Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less
    15240 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less
    15260 Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less
    15271 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
    15273 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
    15275 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
    15277 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
    19316 Mastopexy
    19318 Reduction mammaplasty
    19324 Mammaplasty, augmentation; without prosthetic implant
    19325 Mammaplasty, augmentation; with prosthetic implant
    19328 Removal of intact mammary implant
    19330 Removal of mammary implant material
    19340 Immediate insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
    19342 Delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
    19350 Nipple/areola reconstruction
    19355 Correction of inverted nipples
    19357 Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion
    19361 Breast reconstruction with latissimus dorsi flap, without prosthetic implant
    19364 Breast reconstruction with free flap
    19366 Breast reconstruction with other technique
    19367 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site;
    19368 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site; with microvascular anastomosis (supercharging)
    19369 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), double pedicle, including closure of donor site
    19370 Open periprosthetic capsulotomy, breast
    19371 Periprosthetic capsulectomy, breast
    19380 Revision of reconstructed breast
    19396 Preparation of moulage for custom breast implant
    --------------------------------------------------------------------------------------
    Excludes Application of skin substitute to an external wound (15271-15278)
    Excludes Mesh implantation for:
    Excludes Open repair of ventral or incisional hernia (49568)
    Excludes Repair of devitalized soft tissue infection (49568)
    Excludes Repair of pelvic floor (57267)
    Plastic, Reconstructive, and Aesthetic Surgery

    Coding Tips
    -------------------------------------------------------------------------------------------------------------------
    This code is new for 2012. As an "add-on" code, 15777 is not subject to multiple procedure rules. No reimbursement reduction or modifier 51 is applied. Add-on codes describe additional intra-service work associated with the primary procedure. They are performed by the same physician on the same date of service as the primary service/procedure, and must never be reported as a stand-alone code. The supply of the biologic implant would be reported separately in conjunction with 15777. For a bilateral breast procedure, report 15777 with modifier 50.

  4. #4
    Default
    thank you
    my doctor billed this code by itself for an injection of acell into fistula cavitiy, i guess that what she must bill here is the injection itself right? she injected the acell material in order to granulate the cavity and close off the fistula...

  5. #5
    Location
    Jamaica, NY
    Posts
    28
    Default
    Which CPT would you use?

  6. #6
    Default
    hpcs code we were thinking to use L8699 prostetic implant, but i am not quite sure if this correct could please advise me?

  7. #7
    Default
    Quote Originally Posted by ruthceron View Post
    can somebody advise if is there any proper list of primary codes for 15777? we are cluless in terms of this.
    please help!!
    15777 does not have a set of codes it must be billed with, however, there are codes it may not be billed with including but not limited incisional and ventral hernias. But remember it is for the implantation of a BIOLOGIC (i.e. alloderm-Q4116). In most cases it is used in breast and abdominal wall repairs (removal of large tumor out of the abdomen).

  8. #8
    Default
    Quote Originally Posted by ruthceron View Post
    thank you
    my doctor billed this code by itself for an injection of acell into fistula cavitiy, i guess that what she must bill here is the injection itself right? she injected the acell material in order to granulate the cavity and close off the fistula...
    This would be an incorrect use of the 15777 code, it is never a stand alone code, it is an add-on code. And it is for implantation of a biologic, not injection. For an injection you would want to use an injection code and look for the specific material that is being injected.

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