How To Use CPT Code 15275

CPT 15275 refers to the application of a skin substitute graft to specific body areas, covering a wound surface area up to 100 sq cm. This article will discuss the description, procedure, qualifying circumstances, billing guidelines, documentation requirements, historical information, similar codes, and examples of CPT 15275.

1. What is CPT 15275?

CPT 15275 is a medical billing code used to describe the application of a skin substitute graft to specific body areas, such as the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. This code is applicable when the total wound surface area is up to 100 sq cm, and it covers the first 25 sq cm of the wound surface area. The purpose of this procedure is to prevent infection, cover the wound, enable the skin to heal, and improve the cosmetic appearance of the affected area.

2. 15275 CPT code description

The official description of CPT code 15275 is: “Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area.”

3. Procedure

The 15275 CPT code procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider cleans the wound surface in the specified region with antiseptic.
3. The provider prepares the skin substitute graft according to the shape and size of the wound.
4. The skin substitute graft is transplanted to the now sterile wound area.
5. The provider ensures that the skin substitute graft properly adheres to the wound area.

This procedure helps prevent infection, covers the wound, enables the skin to heal, and improves the cosmetic appearance of the affected area.

4. Qualifying circumstances

Patients eligible to receive CPT code 15275 services are those with wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, with a total wound surface area up to 100 sq cm. The procedure is appropriate for patients who require a skin substitute graft to cover the wound, prevent infection, and promote healing.

5. When to use CPT code 15275

It is appropriate to bill the 15275 CPT code when the provider performs the application of a skin substitute graft to the specified body areas, covering a wound surface area up to 100 sq cm, and the first 25 sq cm or less of the wound surface area. This code should be used when the patient meets the qualifying circumstances and the procedure is medically necessary to prevent infection, cover the wound, and promote healing.

6. Documentation requirements

To support a claim for CPT 15275, the following information should be documented:

• Patient’s medical history and physical examination findings
• Indication for the procedure, including the location and size of the wound
• Type of skin substitute graft used
• Details of the procedure, including anesthesia, wound preparation, graft application, and adherence
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 15275, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 15275 include:

• Use +15276 for each additional 25 sq cm of the wound area.
• For total wound surface area in the specified anatomic region of 100 cm2 or more, or 1 percent of the body area of a child under 10, see 15277 to +15278.
• Ensure that the patient meets the qualifying circumstances and that the procedure is medically necessary.
• Document all required information to support the claim.

8. Historical information

CPT 15275 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates since its addition.

9. Similar codes to CPT 15275

Five similar codes to CPT 15275 and how they differentiate from CPT 15275 are:

1. CPT 15271: Covers the application of a skin substitute graft to the trunk, arms, or legs, with a total wound surface area up to 100 sq cm.
2. CPT 15273: Covers the application of a skin substitute graft to the trunk, arms, or legs, with a total wound surface area of 100 sq cm or more.
3. CPT 15277: Covers the application of a skin substitute graft to the specified body areas, with a total wound surface area of 100 sq cm or more, or 1 percent of the body area of a child under 10.
4. CPT 15278: An add-on code for each additional 100 sq cm of the wound area when using CPT 15277.
5. +15276: An add-on code for each additional 25 sq cm of the wound area when using CPT 15275.

10. Examples

Here are 10 detailed examples of CPT code 15275 procedures:

1. A patient with a 20 sq cm wound on the face receives a skin substitute graft.
2. A patient with a 15 sq cm wound on the scalp undergoes a skin substitute graft application.
3. A skin substitute graft is applied to a 10 sq cm wound on a patient’s eyelid.
4. A patient with a 25 sq cm wound on the neck receives a skin substitute graft.
5. A skin substitute graft is applied to a 5 sq cm wound on a patient’s ear.
6. A patient with a 12 sq cm wound on the hand undergoes a skin substitute graft application.
7. A skin substitute graft is applied to a 22 sq cm wound on a patient’s foot.
8. A patient with a 7 sq cm wound on the genitalia receives a skin substitute graft.
9. A skin substitute graft is applied to a 18 sq cm wound on a patient’s orbit.
10. A patient with a 24 sq cm wound on multiple digits undergoes a skin substitute graft application.