Dermatology Coding Alert

Question: How should I code for harvesting of keratinocytes for skin grafts?

Texas Subscriber
 
Answer: The appropriate codes for application of autogenous skin grafts are 15100-15120. These codes include harvesting of keratinocytes (several cells from which the physician will "culture" new skin for later grafting), as well as the subsequent application of the skin to the area requiring grafting.

Because the only skin grafts that will really grow onto the new location are the ones from our own bodies, this is often done for patients with very extensive burns who do not have enough skin to harvest for the needed grafts (allografts and xenografts, in contrast, are essentially living bandages and will not actually become part of the body).
 
You should choose an appropriate code as determined by the recipient site of the graft, according to CPT.
 
For example, a patient requires extensive grafts following burns of the lower left leg. The physician harvests keratinocytes from several locations and cultures skin for the graft. Later, she applies the graft to a 200-sq-cm area.

For this procedure (including harvesting and culture of keratinocytes), report 15100 (Split graft, trunk, arms, legs; first 100 sq cm or less, or one percent of body area of infants and children [except 15050]) for the first 100 sq cm and +15101 (... each additional 100 sq cm, or each additional one percent of body area of infants and children, or part thereof [list separately in addition to code for primary procedure]) for the remaining 100 sq cm.

 - Answers to You Be the Coder and Reader Questions were reviewed by Linda Martien, CPC, CPC-H, National Healthcare Review in Woodland Hills, Calif.; and William J. Conner, MD, physician at Meridian Medical Group, a multispecialty practice in Charlotte, N.C.