# Acellular dermal replacement vs. acellular dermal allograft



## farobb (Aug 18, 2011)

Can anyone enlighten me as to the difference between these codes (replacement 15175-76 vs. allograft 15330-36)?  No explanation in AAPC Certification Study Guide nor Carol Buck CPC Coding Exam Review.  Need answer ASAP!  Thank you.


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## raykatcar (Aug 18, 2011)

Think 15175 codes are artificial where-as 15330 codes are from cadaver?


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## farobb (Aug 24, 2011)

As acellular is a man-made product, I do not think a cadaver is the donor for the acellular dermal allograft code.  Thanks for replying.


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## laureenj (Aug 24, 2011)

*replacement vs. allograft*

You're both right in my opinion.  Acellular means "engineered" and allograft means from a cadaver (or live donor but since we're talking skin here let's assume it is a cadaver <g>).

Here are my research notes and analysis.

FROM CPT ASSISTANT:
1) Description of Procedure (15170)
Acellular dermal *replacement*, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

After the induction of anesthesia, hemostasis of the graft site is obtained with epinephrine-soaked laparotomy pads and/or a topical hemostatic agent. The acellular dermal replacement is removed from the rinsing solution and a total of 100 sq cm is applied to the trunk and secured to the excised wound with interrupted sutures or surgical staples. A net dressing is applied and expanded over the graft site and secured with staples to prevent mechanical shear. The wound is covered with gauze dressings and secured with a bulky dressing to further prevent mechanical shear.



2) Description of Procedure (15330)
Acellular dermal *allograft*, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

After the induction of anesthesia, hemostasis of the graft site is obtained with epinephrine-soaked laparotomy pads and/or a topical hemostatic agent. Acellular dermal allograft is removed from the transport package. A total of 100 sq cm is applied to the trunk and secured to the wound with absorbable sutures. The dermal graft is covered with a local skin flap (separately coded). The wound is covered with gauze dressings and secured with a bulky dressing to prevent mechanical shear.
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*Laureen's Analysis:*

The 2nd one would be from a cadaver but rather than a straight graft it is “engineered” thus making it an “acellular dermal allograft”.  The 1st one is all engineered and does not use cadaver skin to start with.  It is all man made in other words.

An example of an acellular dermal *allograft* product would be AlloDerm by LifeCELL http://www.lifecell.com/alloderm-regenerative-tissue-matrix/.  It is an “accellular dermal matrix” derived from donated human skin tissue. Donated skin is processed to remove the epidermis.  It's “decellularized” in that various cells, which can cause rejection, are removed. 

An example of an accellular dermal *replacement* product would be Integra by Integra Life Sciences http://integralife.com/Plastic-and-...neName=Soft Tissue Solutions&ProductLineID=78

Thanks Francine for suggesting this as a question for Thursday nights webinar.  See you then!


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