Dermatology Coding Alert

Question: I am confused about whether I can report code 15000 for site preparation. Would you please explain the proper use of this code?

South Carolina Subscriber

Answer: In most cases, when a dermatologist excises a lesion and uses a graft to repair the excision site, the sharp dissection of the excision itself prepares the recipient site (the site of the lesion removal) for the graft. In these cases, you should not report 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
1 percent of body area of infants and children) because the dermatologist prepared the graft site during the excision process.

When the dermatologist excises a complicated lesion, and the procedure requires the dermatologist to complete tissue revision or destruction during the excision process, he may have to further prepare the graft site. When this occurs, you should refer to the operative report for specific details on the extent of the procedure to guide you to the most appropriate code.

Coders most often report code 15000 when dermatologists need to prepare or "clean up" a wound site before applying a graft. The same holds true for grafting on burn sites when the dermatologist must remove a hard, crusted scab, or eschar to place the graft onto healthy tissue.