Dermatology Coding Alert

Question: I'm confused about the skin graft codes. Is site preparation included, or can we report it separately? Do we need a modifier?


Kansas Subscriber

Answer: Yes, you can report site preparation. Site preparation is easy to overlook because it is a standard part of the grafting procedure.

For example, after escharotomy (16035-16036) and debridement (16010-16030) but before placing a skin graft, the dermatologist must prepare the affected area by clearing all remaining eschar, skin debris and subcutaneous tissue.

CPT includes two codes to describe site preparation:

• 15000--Surgical preparation or creation of recipient site by excision of open wounds, burn eschar,  or scar (including subcutaneous tissues); first 100 sq   cm or one percent of body area of infants and children

• +15001--... each additional 100 sq cm or each additional one percent of body area of infants and children (list separately in addition to code for primary procedure).

Note: Code 15001 is an add-on code--use it only in conjunction with 15000.

So even though preparation is a standard part of the procedure, make sure you specify this part of your procedure with the appropriate CPT code so you don't miss out on your full reimbursement. When you bill 15000/15001, make sure the dermatologist's procedure notes clearly state that he performed the preparation along with the size of the area that received the graft.

Example: The dermatologist prepares an area of 14 cm x 14 cm on a burn patient's left leg to receive a skin graft. To determine the area in square centimeters, simply multiply the length of the area by its width. In this case, report 15000 and 15001 to describe the site preparation in a 196-sq-cm area.