How To Use CPT Code 15272

CPT code 15272 describes the application of a skin substitute graft to the trunk, arms, or legs for a total wound surface area up to 100 square centimeters, with each additional 25 square centimeters or part thereof listed separately. 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 15272?

CPT 15272 is used to describe the application of a skin substitute graft to the trunk, arms, or legs for a total wound surface area up to 100 square centimeters, with each additional 25 square centimeters or part thereof listed separately. This code is used when a provider applies a skin substitute, such as an allograft or xenograft, to cover wounds in these specific areas.

2. Official Description

The official description of CPT code 15272 is: ‘Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 15271 for the primary procedure.

3. Procedure

During the procedure, the provider prepares the wound surface in the region of the patient’s trunk, arms, and/or legs by cleaning it with antiseptic. They then prepare the skin substitute graft according to the shape and size of the wound. The provider transplants the skin substitute graft to the wound, ensuring that it properly adheres to the area. This procedure helps prevent infection, covers the wound, promotes healing, and improves the cosmetic appearance of the area.

4. Qualifying circumstances

Patients eligible for CPT 15272 are those who require the application of a skin substitute graft to wounds on their trunk, arms, or legs. The total wound surface area should be up to 100 square centimeters, with each additional 25 square centimeters or part thereof listed separately. The procedure should be performed by a qualified healthcare provider and should be medically necessary for the patient’s condition.

5. When to use CPT code 15272

CPT code 15272 should be used when a provider applies a skin substitute graft to wounds on the patient’s trunk, arms, or legs. This code is specifically for cases where the total wound surface area is up to 100 square centimeters, with each additional 25 square centimeters or part thereof listed separately. It is important to use this code in conjunction with CPT code 15271 for the primary procedure.

6. Documentation requirements

To support a claim for CPT 15272, the provider must document the following information:

• Patient’s diagnosis and the need for the skin substitute graft
• Size and location of the wound
• Details of the skin substitute graft used
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 15272, ensure that the procedure meets the qualifying circumstances described earlier. It is important to use this code in conjunction with CPT code 15271 for the primary procedure. Do not report CPT 15272 in conjunction with CPT codes 15273 or 15274. Additionally, make sure to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT 15272 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 15272

Five similar codes to CPT 15272 include:

• CPT 15271: This code is used for the primary procedure when applying a skin substitute graft to the trunk, arms, or legs for a total wound surface area up to 100 square centimeters.
• CPT 15273: This code is used when the total wound surface area is greater than or equal to 100 square centimeters and up to 150 square centimeters.
• CPT 15274: This code is used when the total wound surface area is greater than 150 square centimeters.
• CPT 15275: This code is used for the application of a skin substitute graft to the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.
• CPT 15276: This code is used for the application of a skin substitute graft to the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, with each additional 100 square centimeters or part thereof.

9. Examples

1. A provider applies a skin substitute graft to a 75 square centimeter wound on a patient’s leg.
2. A provider applies a skin substitute graft to a 125 square centimeter wound on a patient’s arm.
3. A provider applies a skin substitute graft to a 50 square centimeter wound on a patient’s trunk.
4. A provider applies a skin substitute graft to a 90 square centimeter wound on a patient’s leg.
5. A provider applies a skin substitute graft to a 110 square centimeter wound on a patient’s arm.
6. A provider applies a skin substitute graft to a 75 square centimeter wound on a patient’s trunk.
7. A provider applies a skin substitute graft to a 95 square centimeter wound on a patient’s leg.
8. A provider applies a skin substitute graft to a 130 square centimeter wound on a patient’s arm.
9. A provider applies a skin substitute graft to a 60 square centimeter wound on a patient’s trunk.
10. A provider applies a skin substitute graft to an 80 square centimeter wound on a patient’s leg.