Don\'t let confusion over the 20 skin graft codes get you down. Here are four easy steps to help you adopt a systematic, step-by-step approach for reporting every claim so that your dermatology practice won\'t lose out on skin graft reimbursement.
Step 1: Be sure to report site preparation. Site preparation is easy to overlook because it is a standard part of the grafting procedure. For example, after escharotomy (16035-16036) and debridement (16010-16030) but before placing a skin graft, the dermatologist must prepare the affected area by clearing all remaining eschar, skin debris and subcutaneous tissue. CPT Includes two codes to describe site preparation:
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 one percent of body area of infants and children
+15001 - ... each additional 100 sq cm or each additional one percent of body area of infants and children (list separately in addition to code for primary procedure).
So even though preparation is a standard part of the procedure, make sure you specify this part of your procedure with the appropriate CPT code so you don\'t miss out on your full reimbursement. When you bill 15000/15001, make sure the dermatologist\'s procedure notes clearly state that he or she performed the preparation along with the size of the area that received the graft.
For example, the dermatologist prepares an area of 14 cm x 14 cm on a burn patient\'s left leg to receive a skin graft. To determine the area in square centimeters (sq cm), simply multiply the length of the area by its width. In this case, report 15000, 15001 to describe the site preparation in a 196-sq-cm area.
Step 2: Specify the skin \"donor.\" When donor skin completes the graft, the donor skin source determines your code choices, says M. Trayser Dunaway, MD, a physician in Camden, S.C. Possible sources include:
1. The patient\'s own skin, which the dermatologist transports from one area to another. Such grafts are further classified as:
split thickness (15100-15121), which is a thin skin layer from a donor site and includes both epidermis and some dermis. When reading documentation, note that dermatologists typically abbreviate \"split-thickness skin graft\" as \"STSG.\"
full thickness (15200-15261), which is a thicker skin layer from a donor site and includes all of the epidermis and dermis.
2. The dermatologist places human skin from a donor other than the patient (including a cadaver). These grafts are called [...]