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Autografts

Vaida Posted Tue 18th of November, 2014 15:32:49 PM

Hi. I have some doubts about Autografts. Can you please take a look at the examples bellow and give us proper CPT codes and modifiers for them. I understand this will count as 5 questions on my account.

Case 1: Adult patient with 3 split-thickness autografts: left upper arm 3x17 cm (51 cm²), left lower arm 5x15 cm (75cm²), right upper arm 4x16 cm (64 cm²).

Case 2: Adult patient with 3 split-thickness autografts: left upper arm 3x17 cm (51 cm²), scalp 7x7cm (49 cm²), genitalia 3x4 cm (12 cm²).

Case 3: Adult patient with 2 split-thickness autografts on left lower arm 5x15 cm (75cm²), and scalp 8x8cm (64 cm²), and one tissue cultured skin autograft on right leg 5x15 cm (75cm²).

Case 4: Adult patient with one split-thickness autografts on left lower arm 5x15 cm (75cm²), and two tissue cultured skin autografts: left upper arm 5x5 cm (25 cm²), scalp 4x5cm (20 cm²).

Case 5: Adult patient with 4 tissue cultured skin autografts: genitalia 3x4 cm (12 cm²), left lower arm 5x15 cm (75cm²), right upper arm 5x17 cm (85 cm²), and scalp 8x8cm (64 cm²)

Thank you!

SuperCoder Answered Wed 19th of November, 2014 08:17:54 AM

Case 1: Adult patient with 3 split-thickness autografts: left upper arm 3x17 cm (51 cm²), left lower arm 5x15 cm (75cm²), right upper arm 4x16 cm (64 cm²).

Answer- 15100, 15101

15100 represents 'Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)'.

15101 represents 'Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)'.

Four remaining cases, please post four different questions. Thanks !!

Vaida Posted Wed 19th of November, 2014 11:09:01 AM

Thank you so much!!! So just to clarify - you have to add the total area for all of them even though the autografts were performed on different anatomical areas (left arm and right arm)? You can't report 15100 three times?

SuperCoder Answered Thu 20th of November, 2014 02:02:30 AM

Yes, you can not report 15100 three times. You are right, when using graft for multiple wounds, you need to sum the surface area of all wounds from all anatomic sites that are grouped into same code descriptor.

Thanks !!

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