Podiatry Coding & Billing Alert

Question: We are applying skin substitute grafts to ankle ulcers, and I have a question about code selection? Is the ankle considered part of the foot or the leg? I am trying to decide between 15271 or 15275.

Alaska Subscriber

 Answer: The correct answer in this case is 15271 (Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area).

“Procedures involving wrist and/or ankle are reported with codes that include arm or leg in the descriptor,” according to CPT^® guidelines.

Some other important details to remember when reporting skin substitute grafts for the ankle:

• Terms you may see for skin substitute grafts include allograft, acellular dermal allograft, tissue cultured allogeneic dermal substitute skin substitute, tissue cultured allogeneic dermal substitute, xenograft, or acellular xenograft implant.
• You must know the measurement of the graft because this information will dictate your code choice. According to the code descriptors, you would report 15271 or +15272 (Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)) for total wound surface area up to 100 sq cm. However, if the total wound surface area is greater than or equal to 100 sq. cm, you would look to 15273 (Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children) or +15274 (… each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)), instead.
• You can report +15272 in conjunction with 15271, according to CPT^®.
• You should not report 15271 or +15272 in conjunction with 15273 or +15274.