# Help!



## sward (Mar 29, 2010)

My doctor (plastic surgeon) has had to to do a very large (1200 sq cm) full thickness skin graft on a patients arm that was nearly amputated. I am having trouble with coding this. Mostly because when I look up the code for full thickness skin graft 15220 it only allows for 20sq cm then 15221 for each additional 20sq cm. At that rate to cover I will need to bill 15220 x 1 & 15221 x 59. Is that right? 59 add on codes? Is there a better code to use? Can anyone point me in the right direction.

Thanks
Sheila


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## gherimicheleCPC (Mar 29, 2010)

Wouldn't your codes fall in 15300-15336?


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## FTessaBartels (Mar 29, 2010)

*Your coding is correct*

Your coding is correct *IF* it was truly 1200 sq cm of full thickness skin graft ... But my stars, that's a HUGE area (basically the entire arm) ... and where was the donor site ... had to be the patient's entire back or entire thigh. 

I'm thinking gherimichelle may be on to something...

Can you post the scrubbed note?

F Tessa Bartels, CPC, CEMC


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## mitchellde (Mar 29, 2010)

Are you sure this was 1200cm? maybe it was mm, 1200 cm if it were a square would be roughly 19.6 ft x 19.6 ft  That is a huge amount of skin as a full thickness graft.  I am with Tessa on this, please post the note if you can.


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## gherimicheleCPC (Mar 29, 2010)

I know.  Michele is right.....that would have to one huge person.  The note would be interesting.


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## gherimicheleCPC (Mar 29, 2010)

OOps I meant Debra.


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## FTessaBartels (Mar 30, 2010)

*Sq Cm  vs  CM 2*



mitchellde said:


> Are you sure this was 1200cm? maybe it was mm, 1200 cm if it were a square would be roughly 19.6 ft x 19.6 ft  That is a huge amount of skin as a full thickness graft.  I am with Tessa on this, please post the note if you can.



30cm x 40cm =  1200 sq cm  (about the size of the surface area of an adult's entire arm)

*Not* the same as 1200² cm  (1200 x 1200 = 1,440,000 sq cm)
(And we thought we'd never need that freshman year algebra stuff again!)

But that is STILL a huge area for FULL thickness graft.

And maybe it was mm ... that would certainly make more sense  
30mm x 40 mm = 1200 sq mm  or 12 sq cm
But then, Sheila states in original post that arm was nearly amputated. I'm wondering if this was a degloving injury?

Please post the note if you can, Sheila ... or at least that portion that refers to the measurments.  

F Tessa Bartels, CPC, CEMC


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