Thursday, August 4, 2011

HCPCS Level II Codes G0440-G0441 Can be Used for Either Apligraf or Dermagraft


Two G codes - G0440-G0441 - to report your surgeon's work this year.

This year you can turn to two G codes - G0440, G0441 - when your surgeon applies a tissue-cultured skin or dermal substitute for Medicare patients with lower extremity ulcers owing to venous statis or diabetes. This is a welcome change from using the CPT codes for the service, which depend on the type of skin or dermal substitute as follows:






  • Apligraf -- 15340-+15341
  • Dermagraft -- 15360-+15361 or 15365-+15366
    For most non-Medicare payers, you should continue to use the 15300-series codes.

    Cause of concern: General surgeons, podiatrists, plastic surgeons and wound care specialists were worried that Apligraf had a 90-day global period in comparison to Dermagraft, which had a 30-day global period. This lead to a lot of confusion as it caused providers to use one product over another to get financial advantage. But with the new G codes around, not anymore.

    Codes G0440-G0441 to the rescue: Codes G0440-G0441 can be used for either Apligraf or Dermagraft. These HCPCS medical codes ( Source "http://www.supercoder.com/hcpcs-codes/" )have a 0 global days and include the site preparation and debridement services.

    The just-in codes together with a 0-day global billing period will do away with unequal financial incentives in the selection of products for the treatment of chronic wounds as well as help ensure that physicians make their treatment decisions based solely on clinical advantage.

    The road ahead: The Centers for Medicare & Medicaid is working on valuing G0440 and G0441 this year to pave the way for CPT 2012 to offer category III codes to replace the temporary G codes.
  • No comments:

    Post a Comment