How To Use CPT Code 15277

CPT code 15277 describes the application of a skin substitute graft to various areas of the body, including the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and multiple digits. 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 15277?

CPT 15277 is used to describe the application of a skin substitute graft to specific areas of the body. This procedure is performed to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and multiple digits. The total wound surface area must be greater than or equal to 100 square centimeters for patients aged 10 and older, or 1% of the body area for children under 10.

2. Official Description

The official description of CPT code 15277 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 greater than or equal to 100 sq cm first 100 sq cm wound surface area, or 1% of body area of infants and children.’

3. Procedure

The procedure for CPT 15277 involves the application of a skin substitute graft to the specified areas of the body. The provider begins by preparing the wound surface in the region of the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. This includes cleaning the wound with antiseptic.

Next, the provider prepares the skin substitute graft according to the shape and size of the wound. The graft is then transplanted onto the wound, ensuring that it properly adheres to the area. This procedure helps prevent infection, covers the wound, and promotes healing. It also improves the cosmetic appearance of the affected area.

4. Qualifying circumstances

CPT 15277 is used for patients with wounds on specific areas of the body that meet the qualifying criteria. The total wound surface area must be greater than or equal to 100 square centimeters for patients aged 10 and older, or 1% of the body area for children under 10. The procedure is typically performed by a healthcare professional who is trained in applying skin substitute grafts.

5. When to use CPT code 15277

CPT code 15277 should be used when a skin substitute graft is applied to the specified areas of the body and the wound surface area meets the qualifying criteria. It is important to accurately document the size of the wound and ensure that it meets the requirements for this code.

6. Documentation requirements

To support a claim for CPT 15277, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for a skin substitute graft
• Size of the wound surface area
• Specific areas of the body where the graft was applied
• Details of the procedure, including prepping the wound and applying the graft
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 15277, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the size of the wound and the areas of the body where the graft was applied. If additional grafts are applied to the same patient, use the add-on code 15278 for each additional 100 square centimeters or 1% of body area for infants and children.

8. Historical information

CPT 15277 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 15277

There are several similar codes to CPT 15277 that may be used for different scenarios. These include:

• CPT 15271: Application of skin substitute graft to trunk, arms, and/or legs; first 100 sq cm wound surface area, or 1% of body area of infants and children
• CPT 15272: Application of skin substitute graft to trunk, arms, and/or legs; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children
• CPT 15273: Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm wound surface area, or 1% of body area of infants and children
• CPT 15274: Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children
• CPT 15278: Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)

9. Examples

1. A patient with a large scalp wound receives a skin substitute graft to cover the area.
2. A child with burns on their hands and feet undergoes a skin substitute graft to promote healing.
3. An individual with a facial wound receives a skin substitute graft to improve the cosmetic appearance.
4. A patient with multiple digit injuries undergoes a skin substitute graft to aid in the healing process.
5. A person with a genitalia wound receives a skin substitute graft to cover the area and prevent infection.
6. An individual with a neck wound undergoes a skin substitute graft to promote healing and prevent complications.
7. A patient with eyelid injuries receives a skin substitute graft to improve the function and appearance of the eyelids.
8. A person with a mouth wound undergoes a skin substitute graft to aid in the healing process and prevent infection.