Skin Grafts Medical Coding - When to Use One or Two Codes?

Skin Grafts Medical Coding - When to Use One or Two Codes?
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Q: [Skin Grafts] – If you have a patient that is getting an autologous split thickness graft, taken from the thigh and attached to the tip of the nose, is it alright to use one code like 15120 for the harvesting and attachment? Is it OK if you don’t need two codes, how do I know when to use one or two codes for a procedure?

A: The bottom-line is, you’re most likely going to be reporting two codes. When I teach this in class, I tell the students to think about if you’ve ever had to lay sod down. Maybe it’s a new home or you had to dig up your yard and you had to put new grass down because you want to be there more quickly, so you don’t just buy the sod and just plunk it down and hope for the best. You prepare the soil before you lay the sod down so that the roots will take and grow and live there as if it was always there.

It’s the same with skin grafts. We need to prepare that recipient site and then we need to report the grafting code. It’s really a two-code story.

What I did here is I just grabbed a few. There’s many skin grafting codes in the integumentary system so I just grabbed a couple here. On the left hand side, I had the surgical prep bubbles. If you’re familiar with our teaching techniques, we tend to bubble our CPT codes and highlight everything after the semicolon.

These are the two bubbles in the surgical prep. We’ve got the 15002 bubble and the 15004 bubble. The way we teach it is always compare and contrast, what’s the difference between these two bubbles? When you look closely, its location, location, location. So, the first bubble is of the trunk, arm or legs; and the second bubble is of everything else: face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.