How To Use CPT Code 15240

CPT code 15240 describes the procedure for a free full-thickness skin graft of the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet that is 20 cm2 or less in size. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 15240?

CPT 15240 is a code used to describe the procedure for a free full-thickness skin graft of specific areas of the body, including the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. This procedure involves the removal of skin from a donor site and its transfer to the recipient bed. The provider then closes both the donor and recipient sites. The size of the graft must be 20 cm2 or less.

2. Official Description

The official description of CPT code 15240 is: ‘Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet 20 sq cm or less.’

3. Procedure

The procedure for CPT code 15240 involves several steps:

1. The provider assesses the patient’s condition and determines the need for a full-thickness skin graft.
2. A suitable donor site is selected, typically from an area of the body that has excess skin.
3. The provider removes the skin from the donor site, ensuring that the entire dermal layer (epidermis and dermis) is included.
4. The graft is transferred to the recipient bed, which is the area of the body where the graft will be placed.
5. The provider then closes both the donor site and the recipient site, ensuring proper healing and minimizing the risk of infection.

4. Qualifying circumstances

CPT 15240 is used for patients who require a full-thickness skin graft in specific areas of the body, such as the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. The size of the graft must be 20 cm2 or less. This procedure is typically performed to repair damaged or missing skin due to injury, burns, or other medical conditions.

5. When to use CPT code 15240

CPT code 15240 should be used when a provider performs a free full-thickness skin graft in the specified areas of the body, and the size of the graft is 20 cm2 or less. It is important to accurately document the size of the graft and the specific areas of the body involved to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 15240, the provider must document the following information:

• Patient’s diagnosis or condition necessitating the full-thickness skin graft
• Size of the graft (20 cm2 or less)
• Specific areas of the body involved in the graft
• Details of the procedure, including the donor site and recipient bed
• Documentation of the closure of both the donor site and recipient site

7. Billing guidelines

When billing for CPT 15240, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the size of the graft and the specific areas of the body involved. Additionally, be aware of any additional codes that may need to be reported for larger graft sizes or additional procedures performed in conjunction with the skin graft.

8. Historical information

CPT 15240 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 15240

There are several similar codes to CPT 15240 that may be used for different procedures or graft sizes. These include:

• CPT 15241: For each additional 20 cm2 or part thereof, in addition to CPT 15240, for the primary procedure.
• CPT 15040-15261: Range of codes for autografts and tissue cultured autografts, which may be used for different types of grafts or procedures.

9. Examples

1. A patient with a burn injury on their hand requires a 15 cm2 full-thickness skin graft to repair the damaged skin.
2. An individual with a facial injury needs a 10 cm2 full-thickness skin graft on their cheek to reconstruct the damaged area.
3. A patient with a congenital defect on their genitalia requires a 5 cm2 full-thickness skin graft for reconstruction.
4. Someone with a traumatic injury to their foot needs a 20 cm2 full-thickness skin graft to repair the damaged skin.
5. An individual with a facial scar desires cosmetic improvement and undergoes a 12 cm2 full-thickness skin graft on their forehead.
6. A patient with a chronic wound on their neck requires an 18 cm2 full-thickness skin graft for wound closure.
7. Someone with a hand injury needs a 7 cm2 full-thickness skin graft to repair the damaged skin on their palm.
8. An individual with a mouth defect undergoes a 3 cm2 full-thickness skin graft for reconstruction.
9. A patient with a burn injury on their axilla requires a 10 cm2 full-thickness skin graft to repair the damaged skin.
10. Someone with a foot ulcer needs a 6 cm2 full-thickness skin graft for wound healing.