coding debridement with skin graft

CPT codes 11000 and 11001 describe removal of extensive eczematous or infected skin. Medicaid and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration appropriate codes to use when performing a non-surgical application of a skin substitute. 0000022753 00000 n THE UNITED STATES Auto- is different: If you see the term autograft or tissue cultured autograft, then you are dealing with the harvest and/or application of an autologous skin graft. End User License Agreement: When subcutaneous tissue is debrided from a 16 s. cm dehisced abdominal wound and a 10 sq cm thigh wound, report 11042 for the first 20 sq cm and 11045 for the second 6 sq cm. Thank you. Skin Substitute, Oasis wound Matrix, per square centimeter All Rights Reserved. View ICD-10-PCS CODING 2022 - Case Studies and Code Building Exercises.docx from HLTH 1241 at St. John's University. You need to master the different graft options and know how to find the information in the surgeons note, because CPT includes different code sets for each type of graft. All Rights Reserved (or such other date of publication of CPT). Remember that the debridement codes, 11042-11047, are reported when you debride an open wound that will stay open to heal by secondary intention. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures. Skin substitute graft application code selection is based on defect site location and size. The page could not be loaded. Based on what I have read in the Official Guidelines for Coding and Reporting and Coding Clinic for ICD-9-CM, I believe that I should report two separate codes. Do we bill 15271 as the size of the debridement documented or only the size of the skin substitute? The AMA does not directly or indirectly practice medicine or dispense medical services. Debridement is generally associated with injuries, infections, wounds, and/or ulcers. cm and documented 20 sq. that coverage is not influenced by Bill Type and the article should be assumed to Note that debridement of the skin that is preparatory to further surgery, such as reduction of fracture, should not be coded as a separate procedure. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES twZ5C2ayV`C~1S6#9mOk)d4sr$#yd:W8 Eu1EgZ \ 0 E endstream endobj 49 0 obj <>stream The CMS.gov Web site currently does not fully support browsers with endstream endobj 26 0 obj <> endobj 27 0 obj <> endobj 28 0 obj <>stream %PDF-1.5 % 15004 and +15005 for face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits 0000018702 00000 n An official website of the United States government. Codes describing excision debridements deeper than skin only are organized by depth: 2. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not Absence of a Bill Type does not guarantee that the Many claims for debridement are essentially dressing changes and are not separately payable. When debridements are performed, the debridement . If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. This question was answered by Denise Williams, COC, senior vice president of the revenue integrity division and compliance auditor at Revant Solutions in Trussville, Alabama. Therefore, the more accurate code is a surgical preparation code (15002 15005) for excision (note the term is not debridement) of the open wound to prepare a viable wound surface for grafting. For example, debridement of two ulcers on the foot to the level of subcutaneous tissue, total area of 6 sq cm should be billed as CPT code 11042 with unit of service of "1". The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered. 11042 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less + 11045 - each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Tip 2: Identify Type of Skin Substitute Graft Distinguish the codes based on body site, as follows: Each pair of codes identifies the size of the defect created by the surgical preparation, with the first code (15002 or 15004) describing the first 100 sq cm for adults and children aged 10 and up, or 1 percent of body surface area for children under 10 years of age, including infants. Debridement Debridement of subcutaneous tissue (e.g., Current Procedural Terminology (CPT) codes 11042 and 11045, if appropriate) is considered Youre right about the skin graft code(s). Debridement services are now defined by body surface area of the debrided tissue and not by individual ulcers or wounds. When can I report a debridement in addition to a graft? AHA copyrighted materials including the UB‐04 codes and and monitoring is occurring. The American Hospital Association ("the AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the 4. resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; 0000007521 00000 n HLN>bE+hAi .xiJ2D4>"A_6N@f("nChK!`=x;c` DIS!Sf8_c^x)$ 5. Skin replacement surgery consists of two basic steps: surgical preparation of the recipient site and placement of the graft with fixation. copied without the express written consent of the AHA. cm of skin substitute application (15271). In your example, you will be closing the wound. Each pair of codes identifies the size of the defect created by the surgical preparation, with the first code (15002 or 15004) describing the first 100 sq cm for adults and children aged 10 and up, or 1 percent of body surface area for children under 10 years of age, including infants. cm and not just that the size of the skin substitute was 20 sq. To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom 0000015008 00000 n will not infringe on privately owned rights. Procedures involving the wrist and/or ankle are reported with codes that include arm or leg in the descriptor. An ulceration of the distal right leg was also noted and repaired with split thickness skin graft., Assign code 84.3 (revision of amputation stump) and code 86.69 (other skin graft to other sites) for the debridement and closure of the amputation site via split-thickness skin graft. The appearance and size of the wound (e.g., down to fresh bleeding tissue, 7 cm x 10 cm, etc.) 0000010407 00000 n If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. qe<>O &j'>-3c\BMAi`/@SPPkS u6X \[bkjqkXdV41+ahqg& _p,d4ueQ@Ha s0O Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. These codes are primarily used when irrigation and . You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. Skin Lesion Excision Wait for Pathology? You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. Federal government websites often end in .gov or .mil. Report these procedures, when they represent covered, reasonable and necessary services, using the CPT or HCPCS code that most closely describes the service rendered. Another option is to use the Download button at the top right of the document view pages (for certain document types). A: It depends on the documentation. Report 97597 for ulcer debridement down to the subcutaneous tissue. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Tip 1: Capture Site Preparation The objective of the procedure is to . While there is some consensus that repeated debridement may promote more rapid healing of diabetic foot ulcers, the appropriate interval and frequency of debridement depends on the individual clinical characteristics of patients and ulcers. CMS and its products and services are not endorsed by the AHA or any of its affiliates. hb```, cc`a4`` $0oP>+Z5:,PaE$L[R\w0`r`,p{^gnq))&%xBiS*,8yUSc3AOSAk*+L|0$nELLuH0|Rfp1drcH/i*@r? Debridement is considered a separately reportable procedure when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue is removed, or when debridement is carried out separately without an immediate primary closure. Unless specified in the article, services reported under other 0000000016 00000 n This code is based on a wound size (singular or aggregate size; after cleansing, prepping, and/or debriding) minimally of 100 sq cm*. Code 86.69 may be assigned twice, if desired, to show the repair of the leg ulcer.. cm. Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. If the documentation supports that 20 sq. Anesthesia administered by or incident to the provider performing the debridement procedure is not separately payable. However, we do not recommend the 11042 11047 codes. Also, you can decide how often you want to get updates. The National Correct Coding Initiative (NCCI) bundles skin substitute graft codes 15271-+15277 with skin and subcutaneous debridement code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less). When performing debridement of a single wound, report depth using the deepest level of tissue removed. The views and/or positions presented in the material do not necessarily represent the views of the AHA. 30 0 obj <>/Filter/FlateDecode/ID[<4F901E512B94F17305A37551681673A3>]/Index[25 15]/Info 24 0 R/Length 49/Prev 19234/Root 26 0 R/Size 40/Type/XRef/W[1 2 1]>>stream Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. The patient's medical record must contain documentation that fully supports the medical necessity for services included withinthe related LCD. If all four wounds were debrided on the same day, apply modifier 59 Distinct procedural service with either 11042 or 11044, as appropriate. Applicable FARS/HHSARS apply. 43 32 o Total site less than 100 sq cm: 15271 first 25 sq cm or less; +15272 each additional 25 sq cm KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. Answer: %PDF-1.7 % If you miss the separate skin preparation step, youll sacrifice pay your surgeon deserves. apply equally to all claims. This is reported with a single code, 11044. LGXt5q]$]0"$T ?@Z"&&g2~caPa;SS:Sk \SA?3U'VXAHKJ66 R f`p/2XNd@T1 Code 86.22, Excisional debridement, was defined as the "surgical removal or cutting away of devitalized tissue, necrosis, or slough," which could be performed in the operating room, emergency room, or at the patient's bedside. Service: The work described by these codes involves preparing a clean, viable wound surface for graft placement to heal by primary intention (not secondary intention). 6. 0000008118 00000 n In CPT, coding these grafts by size is a novel concept. Revenue Codes are equally subject to this coverage determination. Table 2 summarizes the coding matrix for the new skin substitute graft codes. Code 86.22, Excisional debridement, was defined as the "surgical removal or cutting away of devitalized tissue, necrosis, or slough," which could be performed in the operating room, emergency room, or at the patient's bedside. You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. Replacement material, graft size, multiple wounds all these factors and more [], Dont miss pregnancy impact. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, . Two procedure codes need to be assigned-the excision and the graft closure. cm, equal to, or greater than 100 sq. endstream endobj 1254 0 obj <>/Metadata 102 0 R/OCProperties<>/OCGs[1280 0 R]>>/Outlines 119 0 R/PageLayout/SinglePage/Pages 1245 0 R/StructTreeRoot 186 0 R/Type/Catalog>> endobj 1255 0 obj <>/ExtGState<>/Font<>/Pattern<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 1256 0 obj <>stream My coder says that 11043/11046 is included in 15271 and we can't separately bill for them with 15271. rW`n":Q5g%_7:j)j9."QFGH(2My"hqt}%%l}]KkWmNhlI,(PjqK9%.v#|3^ya%h'e'e2iB@iFOk|q)7 If.ug q&QP;jNy>9cW=aB=je>m3/dDQMA;2VJ0E5&Qj2[iG"^l+E. 1 G/r f VY;fuC{r@,>^Q k1[1Q3#V^DJ;;j!E"&~'/;{1M, ~ B ^(\%@%t m+?Rh@yK CPT codes, descriptions and other data only are copyright 2022 American Medical Association. If you would like to extend your session, you may select the Continue Button. 0000017002 00000 n You need to master the different graft options and know how to find the information in the surgeons note, because CPT includes different code sets for each type of graft. 0000001292 00000 n uKEmc2vy5\^gB:w76>9s=gKn4"=yJ} crv[d[ ML\:6q~6U6_Nc8Dc?nN8^>\RY[qZ{XO*JT!e,(7=m]7}}O@gSS(B"t658>~.%W['i9hch8bQT%ml Supportive Documentation Requirements (required at least every 10 visits) for 97597 and 97598: Medical records must be made available to Medicare upon request. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE, DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS, DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS, DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), Some older versions have been archived. Left axillary artery to left femoral artery bypass with an 8 mm PTFE graft INDICATIONS: . Draft articles are articles written in support of a Proposed LCD. CPT considers debridement a separate procedure only when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure.. See CPT coding guidance for proper use of the coding. Follow our experts tips to make sure you select the proper code and get all the pay your surgeon deserves for these services. If any of these elements is missing, documentation does not meet the criteria for excisional debridement. I performed a simple debridement with a full thickness graft of the trunk and reported 15200 and coded also for the debridement, but my coder told me I could not report the debridement. iC>:D~c~V*H0"Q%L]5CB You're right about the skin graft code (s). Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable. The National Correct Coding Initiative (NCCI) bundles skin substitute graft codes 15271-+15277 with skin and subcutaneous debridement code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less). I work in an acute care center with a burn unit and have been striving for accuracy and consistency. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. All rights reserved. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential Any other conditions that may significantly affect wound healing should also be appropriately addressed in the medical record. Question: Q: I have been trying to determine whether a skin graft includes debridement. For instance, Versajet debridement is considered to be nonsurgical, mechanical debridement because it does not involve cutting away or excising devitalized tissue. Your MCD session is currently set to expire in 5 minutes due to inactivity. All rights reserved, CMS publishes FAQ on modifiers -JW and -JZ, 2023 Revenue Integrity Symposium Justification Letter, 2023 NAHRI Leadership Council participation requirements, 2023 NAHRI Leadership Council research survey released. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. without the written consent of the AHA. Determining the wound location and surface area is important in order to select the appropriate CPT code. Note: This question can be found in the billing and claims category on the NAHRI Forums where you can find answers to questions on a variety of topics from billing and claims to compliance to reimbursement. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. Avoid: Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children), o Similar code pairs based on area: 15275 and +15276; 15277 and +15278. HWAnl))1p9CK,q@:(#"ET.OSnt$v\^lt6btT 9A'w>$bg71w= Y)s.girVu^T_N'%u7Ag>f|vsQ lCN}uCjdgIKLYvO0>E,bRpUuCXX_"RkdEN""/@1] $' O*o5-OEJmq@Hc^VVl 0 o Similar code pairs based on area: 15275 and +15276; 15277 and +15278 U.+"x/J>DcB Response to Comment (RTC) articles list issues raised by external stakeholders during the Proposed LCD comment period. As you can see, procedure code 86.69 (other skin graft to other sites) includes the debridement and closure of the amputation site via split-thickness skin graft. cm). Tip 3: Know Whats Included 2021 Evaluation and Management Codes: Is a History Required? iii. Application of Bioengineered Skin Substitutes and Skin Grafting is performed on ulcers that are free of . 11010 Debridement including removal of foreign material associated with open fracture (s) and/or dislocation (s); skin and subcutaneous tissues. culture and sensitivity), osteomyelitis (e.g. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt. Please do not use this feature to contact CMS. cm or less). {B$0{@-g;E*m ZhP' 94*_@0C"EXOeB0]:w`;d3Qf)2 }q)e]wNa%FS|C|N/\Z ZLA&0aC`+9MA- 9[cBo}gi;>E\H%2PXus |,"y5q+p^$C-y#]+vJ%@|6 : &TI=C$^';Ez^J=SZ-gZ Autologous skin grafts are those that the surgeon harvests from another healthy part of the patients own body, and you would use different codes for those graft procedures. *4 Use CPT code 15340-15341 or CPT code 15360-15366 for the surgical preparation or creation of recipient site for the tissue skin graft. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. In ICD-10-PCS, the user may elect to look in the Index under Advancement which provides options to see Reposition or see Transfer. An asterisk (*) indicates a . Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, Subsequent debridement is often more superficial and best described by CPT codes 97597 or 97598 rather than 11043 or 11044. DISCLOSED HEREIN. 15271-15278 is the new CPT code series for skin substitute grafts. In ICD-9-CM, the Alphabetic Index main term entry is Graft; subterm entry fascia, which directs users to code 83.82, Graft of muscle or fascia. 4 CPT code 15431 is always related to CPT code 15430 and, per the MFSDB is always included in the global period of the other service. 2. You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles, You are leaving the CMS MCD and are being redirected to, AMA CPT / ADA CDT / AHA NUBC Copyright Statement, Article - Billing and Coding: Debridement Services (A56617). CPT codes 11042-11047 should be used for debridement of relatively localized areas depending upon the involvement of contiguous underlying structures. Neither the United States Government nor its employees represent that use of such information, product, or processes Complete absence of all Bill Types indicates U B( B>i ^6XPw1E_H*>4=i"U}`K}1~ymIoq=wza Would also adding Mod 22 help, and for which one 11042 or 11043? Youll find the codes for skin substitute graft procedures in the range 15271-+15278 (Application of skin substitute graft ). Please subscribe today or login for access. 0000008214 00000 n 7500 Security Boulevard, Baltimore, MD 21244. recipient email address(es) you enter. Select Debridement Codes by Depth. In cases of excessive frequency or prolonged duration of treatment, documentation should include an evaluation for possible infection (e.g. Terms: Primary intention means that the edges of the wound or graft are closed to allow them to grow together, while secondary intention refers to allowing an open wound to heal from the base up by building new tissue. 4. Integumentary Procedures: 3 Tips Guide Coding for Skin Substitute Grafts, 3 Tips Guide Coding for Skin Substitute Grafts, Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (, 15002 and +15003 for trunk, arms, legs (including wrist or ankle), 15004 and +15005 for face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, Non-autologous human skin (dermal or epidermal, cellular and acellular) grafts, including allografts (from a person other than the patient) and homografts (from cadavers), Non-human skin substitute grafts such as xenografts (from another animal such as pig), Biological products that form a sheet scaffolding for skin growth. *This response is based on the best information available as of 09/05/19. At a minimum, the Progress Report must document the continuing skilled assessment of wound healing as it has progressed since the evaluation or last Progress Report. There are different article types: Articles are often related to an LCD, and the relationship can be seen in the "Associated Documents" section of the Article or the LCD. 2. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be 465 Wound Debridement and Skin Graft Except Hand, for Musculo-Connective Tissue Disorders without CC/MCC In addition to the type of graft material, the surgeon should also document site preparation and wound size, and number and location of grafts, according to Beresh. The AMA is a third party beneficiary to this Agreement. 3]HE1}}&Z\d3aD)6C~NYZgois\t-w;s3N>dgp@GtBisMaq)%le"Z\g.j4 9qEb*NLaQD\/z a\)DC|[JkHHq\J.d&X. Replacement material, graft size, multiple wounds all these factors and more will come into play when youre coding a skin replacement surgery using skin substitute grafts for conditions such as burns. 0000002478 00000 n The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. Coding matrix for the new skin substitute graft codes For multiple wounds, sum the surface area of all wounds requiring grafts from the same anatomic site and report the applicable primary code and add-on code in multiples, as appropriate. hVmo6+ER|l%v5/:Bm#e'b|x;CA\X&V@[ ElBdd B()"8$^DHhFTDv):7^L]c"BJ#=,'$T#BJ! Copyright 2023, AAPC All rights reserved, Debridement of the skin that is preparatory to further surgery such as reduction of fracture, etc., should not be coded as a separate procedure., The surgeon debrided the necrotic tissue surrounding the amputation site, harvested skin from the patient's thigh and closed the wound with a split thickness skin graft.