CPT Codes for Skin Replacement and Skin Substitute Grafts

Revised CPT instruction clarifies coding.

Although the codes and rules for reporting skin replacement and skin substitutes are not new, ever since 2011 CPT codes added a couple of new introductory sections it certainly looks clearer. Read on and take some lessons on ways to report skin replacement and skin substitute grafts:

When you shouldn't use these codes

There are over 50 codes that describe the various surgical steps and types of skin replacement/substitute procedures in the range 15002 - +15431.

So questions may arise whether you should report the proper codes from this range every time your surgeon makes use of a skin replacement or skin substitute to heal a wound. Well, in this case you shouldn't code a skin replacement or skin substitute application if the surgeon just applies skin replacement/substitute to the wound, even if he makes it stable by dressing.

Instead here's what you should do: You should use these codes only when the skin substitute/graft is anchored using the surgeon's option of fixation. Say for instance it might include adhesives, sutures, or staples.

You should look for documentation of fixation in the op note before you make use of any skin replacement or skin substitute codes.

Be familiar with what ‘application' services include

Many a time surgeons carry out skin replacement or skin substitute grafts post other surgical treatment for distressing wounds, burn eschar, or necrotizing infection. When the surgeon applies and fixes skin or a skin substitute you will need to understand which services you should and should not code in apart from the proper graft code.

You should include dressing: As per CPT instruction, when you report a skin or skin substitute graft, you should not code routine dressing supplies separately. Supplies like A6453 are included in the skin application charge.