How To Use CPT Code 15100

CPT 15100 refers to a split-thickness autograft procedure for the trunk, arms, or legs, specifically for the first 100 sq cm or less, or 1% of the body area of infants and children. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 15100.

1. What is CPT 15100?

CPT 15100 is a medical procedure code that describes a split-thickness autograft for the trunk, arms, or legs. This procedure is performed on infants and children, and it involves the excision and placement of skin grafts for the first 100 sq cm or less, or 1% of the body area. The code is used by healthcare providers to accurately document and bill for this specific procedure.

2. 15100 CPT code description

The official description of CPT code 15100 is: “Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)”.

3. Procedure

The 15100 procedure involves the following steps:

1. The provider selects a suitable donor site on the patient’s trunk, arms, or legs.
2. Local anesthesia is administered to numb the donor site and the recipient site.
3. A dermatome is used to harvest a split-thickness skin graft from the donor site. The graft contains both epidermis and dermis but not full thicknesses.
4. The harvested skin graft is carefully measured to ensure it covers the first 100 sq cm or less, or 1% of the body area of the infant or child.
5. The graft is then placed on the recipient site and secured with sutures, staples, or adhesive strips.
6. A dressing is applied to protect the graft and promote healing.

4. Qualifying circumstances

Patients eligible to receive CPT code 15100 services are infants and children who require a split-thickness autograft for the trunk, arms, or legs. This may be necessary in cases of burns, wounds, or skin loss due to trauma or surgery. The procedure is specifically for the first 100 sq cm or less, or 1% of the body area of the patient.

5. When to use CPT code 15100

It is appropriate to bill the 15100 CPT code when a healthcare provider performs a split-thickness autograft on the trunk, arms, or legs of an infant or child, covering the first 100 sq cm or less, or 1% of the body area. This code should be used for the excision and placement of the graft, and it is not applicable for other types of skin grafts or for procedures on adults.

6. Documentation requirements

To support a claim for CPT 15100, the following information should be documented in the patient’s medical record:

• Indication for the procedure, such as burns, wounds, or skin loss
• Age of the patient (infant or child)
• Location of the donor and recipient sites
• Size of the harvested skin graft (100 sq cm or less, or 1% of body area)
• Details of the procedure, including anesthesia, graft harvesting, placement, and dressing
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 15100, healthcare providers should follow these guidelines:

• Ensure that the procedure is accurately documented in the patient’s medical record, as described in the documentation requirements section.
• Use the appropriate modifiers, if necessary, to indicate any special circumstances related to the procedure.
• For each additional 100 sq cm or 1% of body area (or part thereof), bill separately using CPT code 15101 in addition to the primary procedure code (15100).

8. Historical information

CPT 15100 was added to the Current Procedural Terminology system on January 1, 1990. There have been updates to the code description since then, with the most recent change occurring on January 1, 2007.

9. Similar codes to CPT 15100

Five similar codes to CPT 15100 and how they differentiate are:

1. CPT 15050: This code is for a skin pinch graft procedure, which is different from a split-thickness autograft.
2. CPT 15101: This code is used for each additional 100 sq cm or 1% of body area (or part thereof) for split-thickness autografts, billed in addition to CPT 15100.
3. CPT 15120: This code is for a full-thickness autograft, which involves a thicker layer of skin compared to a split-thickness autograft.
4. CPT 15200: This code is for a full-thickness autograft of the face, scalp, eyelids, mouth, neck, ears, orbits, or genitals, which are different body areas than those covered by CPT 15100.
5. CPT 15220: This code is for a full-thickness autograft of the hands, feet, or multiple digits, which are also different body areas than those covered by CPT 15100.

10. Examples

Here are 10 detailed examples of CPT code 15100 procedures:

1. A 2-year-old child with a burn on the arm requires a split-thickness autograft covering 80 sq cm.
2. A 5-year-old child with a traumatic wound on the leg needs a split-thickness autograft covering 50 sq cm.
3. An infant with a surgical wound on the trunk requires a split-thickness autograft covering 30 sq cm.
4. A 3-year-old child with a burn on the arm needs a split-thickness autograft covering 100 sq cm.
5. A 6-year-old child with a traumatic wound on the leg requires a split-thickness autograft covering 70 sq cm.
6. An infant with a surgical wound on the trunk needs a split-thickness autograft covering 40 sq cm.
7. A 4-year-old child with a burn on the arm requires a split-thickness autograft covering 90 sq cm.
8. A 7-year-old child with a traumatic wound on the leg needs a split-thickness autograft covering 60 sq cm.
9. An infant with a surgical wound on the trunk requires a split-thickness autograft covering 20 sq cm.
10. A 1-year-old child with a burn on the arm needs a split-thickness autograft covering 10 sq cm.