cpt 15271, cpt code 15271, 15271 cpt code

How To Use CPT Code 15271

CPT 15271 refers to the application of a skin substitute graft to the trunk, arms, or legs, covering a wound surface area up to 100 sq cm. This article will discuss the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 15271 procedures.

1. What is CPT 15271?

CPT 15271 is a medical billing code used to describe the application of a skin substitute graft to a patient’s trunk, arms, or legs, covering a wound surface area up to 100 sq cm. This code is specifically used for the first 25 sq cm or less of the wound surface area. The procedure involves the use of a skin substitute, such as an allograft or xenograft, to cover wounds and promote healing while preventing infection and improving the cosmetic appearance of the wound area.

2. 15271 CPT code description

The official description of CPT code 15271 is: “Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area.”

3. Procedure

The 15271 procedure involves the following steps:

  1. The patient is appropriately prepped and anesthetized.
  2. The provider cleans the wound surface on the patient’s trunk, arms, and/or legs 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, and enables the skin to heal while improving the cosmetic appearance of the wound area.

4. Qualifying circumstances

Patients eligible to receive CPT code 15271 services are those with wounds on their trunk, arms, or legs that require the application of a skin substitute graft. The wound surface area must be up to 100 sq cm, and this code specifically covers the first 25 sq cm or less of the wound surface area. Patients with larger wound surface areas or wounds in different anatomic regions may require additional codes or procedures.

5. When to use CPT code 15271

It is appropriate to bill the 15271 CPT code when a provider applies a skin substitute graft to a patient’s trunk, arms, or legs, covering a wound surface area up to 100 sq cm, and specifically for the first 25 sq cm or less of the wound surface area. This code should be used when the procedure is medically necessary and meets the qualifying circumstances outlined above.

6. Documentation requirements

To support a claim for CPT 15271, the following information should be documented:

  • Patient’s medical history and relevant diagnoses
  • Indication for the skin substitute graft procedure
  • Size and location of the wound(s)
  • Type of skin substitute graft used (e.g., allograft, xenograft)
  • Details of the procedure, including anesthesia, wound preparation, graft application, and adherence
  • Post-procedure care instructions and follow-up plans

7. Billing guidelines

When billing for CPT code 15271, it is important to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 15271 include:

  • Use add-on code +15272 for each additional 25 sq cm of the wound area.
  • For total wound surface areas of 100 cm2 or more, or one percent of the body area of a child under 10, use codes 15273 and +15274.
  • If a split-thickness autograft is used, use code 15120 instead of 15050.
  • When multiple areas represented by different codes require different grafts, use a modifier indicating different sites.

8. Historical information

CPT 15271 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Similar codes to CPT 15271

Five similar codes to CPT 15271 and how they differentiate from CPT 15271 are:

  1. CPT 15272: This add-on code is used for each additional 25 sq cm of the wound area when billing for CPT 15271.
  2. CPT 15273: This code is used for the application of a skin substitute graft to a total wound surface area of 100 cm2 or more, or one percent of the body area of a child under 10.
  3. CPT 15274: This add-on code is used for each additional 100 sq cm of the wound area when billing for CPT 15273.
  4. CPT 15120: This code is used for the application of a split-thickness autograft instead of a skin substitute graft.
  5. CPT 15050: This code is used for the application of a skin graft without the use of a skin substitute.

10. Examples

Here are 10 detailed examples of CPT code 15271 procedures:

  1. A patient with a 20 sq cm burn wound on their forearm receives a xenograft.
  2. A patient with a 15 sq cm diabetic ulcer on their lower leg receives an allograft.
  3. A patient with a 25 sq cm surgical wound on their abdomen receives a tissue cultured allogeneic dermal substitute.
  4. A patient with a 10 sq cm pressure ulcer on their upper arm receives an acellular dermal allograft.
  5. A patient with a 22 sq cm traumatic wound on their thigh receives a skin substitute graft.
  6. A patient with a 18 sq cm wound on their calf due to a skin infection receives an acellular xenograft implant.
  7. A patient with a 24 sq cm wound on their back from a skin cancer excision receives a tissue cultured allogeneic dermal substitute skin substitute.
  8. A patient with a 12 sq cm wound on their forearm from a dog bite receives an allograft.
  9. A patient with a 20 sq cm wound on their lower leg due to a motorcycle accident receives a xenograft.
  10. A patient with a 16 sq cm wound on their upper arm due to a skin graft donor site receives a tissue cultured allogeneic dermal substitute.

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