Podiatry Coding & Billing Alert

Question: I need help with coding debridement of full thickness nonhealing foot ulcer with application of 2cc Graft Jacket Express and 4x4 Graft Jacket. What codes should I report?

Illinois Subscriber

Answer: HCPCS codes Q4107 (Skin substitute, graft jacket, per square centimeter), and Q4113 (Allograft, graft jacket express, injectable, 1cc) represent services that may be associated with the use of Graft Jacket and Graft Jacket Express, respectively.

They replaced J7344 (Dermal [substitute] tissue of human origin, with or without other bioengineered or processed elements, without metabolically active elements, per square centimeter) and J7346 (Dermal [substitute] tissue of human origin, injectable with or without other bioengineered or processed elements, but without metabolized active elements, 1cc) in 2009.

Background: Graft Jacket is a human tissue product used in fixing large and massive reparable rotator cuff tears.

More References: You can get the coding for skin substitutes from the Medicare website. If you're in the Virginia area, you can refer to www.trailblazerhealth.com (In the Local Coverage Determination portion, look up skin substitutes).