This year there are a couple of temporary G codes that you need to use.
In a particular situation, your dermatologist applies a tissue-cultured skin or dermal substitute for Medicare patients with lower extremity ulcers owing to venous stasis or diabetes. If you are to report such a situation, you have a couple of temporary 'G' codes for the present year.
Be it Apligraf or Dermagraft, you should zero in on G0440 and G0441 to report your surgeon's work in the present year. This is a change from using the current CPT codes for the service, which depend on the type of skin or dermal substitutes which are: Apligraf -- 15340-+15341, Dermagraft -- 15360-+15361.
Note: For most non-Medicare payers you should continue to use the 15300-series codes.
Sometimes your surgeon may prefer one skin or dermal substitute product or the other for clinical reasons in particular cases. In such cases coverage quirks for the CPT codes can provide payment cracks that sway product choice.
Challenge: What was worrying for general surgeons, podiatrists, plastic surgeons and wound care specialists was that Apligraf had a 90-day global period in comparison to Dermagraft, which had a 30-day global period. This lead providers to use one product over another to get financial advantage.
What's more, 15340-+15341 include site preparation and debridement, when you can bill those services separately with 15360-+15366.
Utilized for either Apligraf or Dermagraft, codes G0440-G0441 have 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 along with ensuring that physicians make their treatment decisions based on clinical benefit only.
In the future: For new or revised codes pertaining to these services, look to CPT 2012.
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