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surgical preparation

Deaconess Posted Wed 01st of August, 2018 15:17:15 PM
Can you please clarify when to use the surgical preparation codes (15002, etc.). I have always been told its only for acute and/or traumatic wounds, and only once per wound. Then got this info in a webinar: Diagnosis: Chronic non-healing ulcer of both medial malleoli Procedure: Sharp debridement and excision of necrotic fibrinous tissue with placement of Acell MicroMatrix products on both legs On the right leg, he has 4 x 5 cm wound that is sharply debrided with #15 blade and excised of any remaining fibrinous tissue, then followed by 5 x 5 Acell surgical sheath. Similarly on the left leg, there is a 8 x 6 cm wound that was debrided and excised of fibrinous tissue and then followed by placement of 8 x 10 cm sheath 15002, Surgical preparation or creation of recipient site by excision of open wounds, legs, first 100 sq cm 15271, application skin substitute graft, legs, first 25 sq cm; 15272, additional 25 sq cm x 2
SuperCoder Answered Thu 02nd of August, 2018 07:24:20 AM

Hi Deaconess,

 

Thank you for your Question.

 

The type of graft placed will help in finding surgical preparation code, For preparation of wounds on the trunk, arms, and/or legs CPT code15002 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar [including subcutaneous tissues], or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or one percent of body area of infants and children) may be reported to describe the site preparation.

 

The total area the surgeon prepared if exceeds 100 sq cm, then Cpt code +15003 (... 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]) would be appropriately billable code.

 

For preparation of wounds of the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, report 15004 for the first 100 sq cm of site prep. For additional preparation (beyond 100 sq cm) in the same anatomic areas, report add-on 15005-only in addition to 15004

 

CPT direct for the use of these code you to 15002-15005 "for initial wound recipient site preparation." As the site preparation is separate from escharotomy, debridement and (in most cases) placement of the graft itself.

  1. As per the CPT Code Book codes CPT codes 15002-15005 are not appropriately billable when performing a non-surgical application of a skin substitute.

 

  1. These CPT codes 15002-15005 are only appropriately used in place of service inpatient hospital, outpatient hospital or ambulatory surgical centre with regional or general anaesthesia.

 

  1. These CPT codes are applicable for procedures performed to resurface an area damaged by burns, traumatic injury or surgery.

 

As supported by documentation, site prep codes are assigned according to the anatomic area and total body surface area involved:

 

 

15002 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children

 

+15003 each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)

 

 

15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children

 

 

+15005 each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)

 

 

Surgical preparation for wound care may be reported only once per wound. If the wound is prepared, but not grafted for example grafting would not performed until the next day, minimal wound bed preparation is included in the graft code, as previous graft is removing.

 

Site preparation codes are mostly coded with skin replacement surgery (15100-15278), modifier 51 Multiple procedures may be added to site preparation CPT codes 15002 or 15004 or sometimes, payer specific.

 

Do not append modifier 51 to 15003 or 15005; as these are add-on codes, they are multiple procedure exempt codes.

 

Hope this helps!

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