CPT 2006 Shows More Skin--and New Technologies Will Benefit
Published on Mon Jan 09, 2006
You-ll have to differentiate between layers of skin when applying graft codes Skin graft technology has advanced tremendously in recent years--and CPT has finally caught up. With a host of new and revised codes for 2006, CPT gives you the specificity you need--and with hope, the reimbursement you deserve--for new grafting techniques.
The overview: CPT has renamed the -Free Skin Grafts- subsection -Skin Replacement Surgery and Skin Substitutes.- This portion of CPT adds 37 brand-new codes, revises five codes and deletes four codes, and now includes a total of 54 codes (up from just 21 in 2005).
The advantages: Many of the new codes seem designed to represent some new techniques and procedures, says Teresa Thompson, CPC, CCC, with TM Consulting in Sequim, Wash. They include new codes for autografts (15100-15157), acellular dermal replacements (15170-15176), allografts (15300-15336), skin substitutes (15340-15366) and xenografts (15400-15431). Many of the codes are specific to particular products or technologies.
Until now, you have struggled to get paid for some of these expensive and specialized products using a general skin graft code, says John Bishop, PA-C, CPC, president of Bishop & Associates in Tampa, Fla. These include products such as Dermagraft, Integra, Appligraft and Biobrane. Harvest a Code for Harvesting Cultured Autograft You may now report harvesting of keratinocytes and dermal tissue for tissue-cultured skin grafts separately, when performed. The new code for harvesting cultured skin autograft is 15040 (Harvest of skin for tissue cultured skin autograft, 100 sq cm or less).
In the past, you could only report cultured skin graft harvests separately by reporting a biopsy code, which really didn't describe the procedure properly. As a result, many payers wouldn't reimburse the procedure separately, either, Bishop says. Describe Depth With New Codes The expansion of the skin graft CPT codes allows coders to specify the depth of the graft and/or the graft material the surgeon uses. The range of codes for autologous (autogenous) skin grafts (15100-15261), for instance, now includes codes for:
- split thickness autografts--15100-15101 and 15120-15121
- epidermal autografts--15110-15116
- dermal autografts--15130-15136
- tissue cultured epidermal autograft--15150-15157
- acellular dermal replacements (also called neodermis, skin substitute, AlloDerm or Dermagraft)--15170-15176. The new codes are good news to Linda Martien, CPC, CPC-H, overseer of coding operations at National Healing Corporation of Boca Raton, Fla. -They have exploded the specificity for skin graft coding to a whole new level. Instead of the previous free skin graft and flap codes, we now have all of these wonderfully specific codes to use,- she says. -I-m particularly pleased to see the differentiation between the layers of skin (epidermal vs. dermal) and the acellular and tissue cultured codes.- Surface Area and Location Matter Almost all of the new codes for special grafts specify a primary code [...]
