Halt 15340, 15360 'global days' prejudice. When your dermatologist applies a tissue-cultured skin or dermal substitute for Medicare patients with lower extremity ulcers due to venous stasis or diabetes, you have two temporary "G" codes you should be using this year. Shift From CPT® to HCPCS for Medicare Whether Apligraf or Dermagraft, you should use G0440 (Application of tissue cultured allogeneic skin substitute or dermal substitute; for use on lower limb, includes the site preparation and debridement if performed; first 25 sq cm or less) and G0441 (... each additional 25 sq cm) to report your surgeon's work in 2011. That's a change from using existing CPT® codes for the service, which depend on the type of skin or dermal substitute as follows: You should continue to use the 15300-series codes for most non-Medicare payers. Lose the Brand Incentive Although your surgeon may prefer one skin or dermal substitute product or the other for clinical reasons in specific cases, coverage quirks for the CPT® codes can provide payment loopholes that sway product choice. Problem:
Also, 15340-+15341 include site preparation and debridement, while you can bill those services separately with 15360-+15366.
Solution:
Used for either Apligraf or Dermagraft, codes G0440-G0441 have 0 global days and include the site preparation and debridement services. "The new codes, together with a 0-day global billing period, will eliminate unequal financial incentives in the selection of products for the treatment of chronic wounds as well as help ensure that physicians make their treatment decisions based solely on clinical benefit," states Geoff MacKay, CEO of Organogenesis in a press release.Look ahead:
Look to CPT® 2012 for new or revised codes regarding these services.