How To Use CPT Code 15261

CPT code 15261 describes the use of a full-thickness skin graft for the nose, ears, eyelids, and/or lips. 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 15261?

CPT 15261 is a code used to describe the application of a full-thickness skin graft for the nose, ears, eyelids, and/or lips. This code is specifically used for each additional graft of 20 square centimeters or part thereof. It is important to note that CPT code 15261 should be reported in conjunction with a code for the primary procedure, which is represented by CPT code 15260.

2. Official Description

The official description of CPT code 15261 is: ‘Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure).’ It is important to remember that repair of the donor site requiring a skin graft or local flaps is considered a separate procedure.

3. Procedure

The procedure for CPT code 15261 involves the application of a full-thickness skin graft to the nose, ears, eyelids, and/or lips. The provider removes the skin from the donor site and transfers it to the recipient bed. Both the donor and recipient sites are then closed. This code is used for each additional graft of 20 square centimeters or part thereof.

4. Qualifying circumstances

CPT code 15261 is used for patients who require a full-thickness skin graft for the nose, ears, eyelids, and/or lips. This procedure is typically performed to repair or replace defective or missing tissue or structures in these areas. It is important to note that the repair of the donor site requiring a skin graft or local flaps is considered a separate procedure.

5. When to use CPT code 15261

CPT code 15261 should be used when a full-thickness skin graft is performed on the nose, ears, eyelids, and/or lips. This code is specifically used for each additional graft of 20 square centimeters or part thereof. It is important to report this code in conjunction with the primary procedure code, which is represented by CPT code 15260.

6. Documentation requirements

To support a claim for CPT code 15261, the provider must document the following information:

• Patient’s diagnosis and the need for a full-thickness skin graft
• Size of the graft in square centimeters
• Date of the procedure
• Details of the procedure, including the removal of skin from the donor site and its application to the recipient bed
• Closure of both the donor and recipient sites
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 15261, it is important to remember that this code should be reported in conjunction with the primary procedure code, which is represented by CPT code 15260. Additionally, it is crucial to note that repair of the donor site requiring a skin graft or local flaps is considered a separate procedure. Therefore, it should not be included in the reporting of CPT code 15261.

8. Historical information

CPT code 15261 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2009, there was a change to the code description, specifying that it includes direct closure of the donor site.

9. Similar codes to CPT 15261

There are several similar codes to CPT code 15261 that are used for different procedures. These include:

• CPT 15260: This code represents the primary procedure for a full-thickness skin graft of the nose, ears, eyelids, and/or lips.
• CPT 67961 – 67975: These codes are used for repair procedures specifically for the eyelids.

9. Examples

1. A patient undergoes a full-thickness skin graft on their nose due to a defect caused by trauma.
2. A individual requires a full-thickness skin graft on their ears to repair damage caused by a previous surgery.
3. A patient undergoes a full-thickness skin graft on their eyelids to correct a congenital abnormality.
4. An individual requires a full-thickness skin graft on their lips to repair damage caused by a burn.
5. A patient undergoes a full-thickness skin graft on their nose and ears to reconstruct facial features after a tumor removal.
6. An individual requires a full-thickness skin graft on their eyelids to correct a cosmetic concern.
7. A patient undergoes a full-thickness skin graft on their lips to repair damage caused by a dog bite.
8. An individual requires a full-thickness skin graft on their nose to reconstruct a nasal deformity.
9. A patient undergoes a full-thickness skin graft on their ears to repair damage caused by frostbite.
10. An individual requires a full-thickness skin graft on their eyelids to correct a functional impairment.