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The procedure described by CPT® Code 15260 involves the harvesting of a full-thickness skin graft from a designated donor site, which may include areas such as the nose, ears, eyelids, and/or lips. A full-thickness graft is characterized by the inclusion of all layers of the skin, which encompasses the epidermis, dermis, and subcutaneous fat, along with associated blood vessels. This type of graft is essential for reconstructive purposes, particularly in areas where cosmetic and functional integrity is critical. After the graft is harvested, the donor site is closed directly, ensuring minimal scarring and optimal healing. The harvested graft is then meticulously positioned over the defect area, which is the site requiring repair. Following the placement of the graft, both the defect area and the graft itself are secured in place using sutures, promoting proper adherence and healing. This procedure is specifically indicated for defects that do not exceed 20 square centimeters in size. For larger defects, additional coding with CPT® Code 15261 is required to account for each additional 20 square centimeters or any portion thereof, ensuring accurate reporting and reimbursement for the services rendered.
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The procedure associated with CPT® Code 15260 is indicated for the repair of defects located on the nose, ears, eyelids, and/or lips. These defects may arise from various causes, including trauma, surgical excision of tumors, congenital anomalies, or other skin conditions that necessitate reconstruction. The use of a full-thickness graft is particularly beneficial in these areas due to the need for both aesthetic and functional restoration, as the graft provides a durable and cosmetically acceptable result.
The procedure begins with the physician identifying an appropriate donor site from which to harvest the full-thickness graft. This site is typically selected based on the quality of the skin and its proximity to the defect. Once the donor site is determined, the physician carefully excises a section of skin that includes all layers, ensuring that the graft is of sufficient size to cover the defect, which must not exceed 20 square centimeters. After harvesting the graft, the physician proceeds to close the donor site directly, which may involve suturing the skin edges together to promote optimal healing and minimize scarring.
Following the closure of the donor site, the physician prepares the defect area by cleaning and assessing it for any debris or necrotic tissue. The harvested graft is then positioned over the defect, ensuring that it aligns properly with the surrounding skin. The graft is secured in place using sutures, which may be placed around the perimeter of the graft to ensure adherence and to facilitate healing. This meticulous process is crucial for the success of the graft, as it must integrate with the surrounding tissue to restore both function and appearance.
After the procedure, the patient is typically monitored for any immediate complications, such as bleeding or infection. Post-operative care instructions are provided, which may include guidelines on wound care, signs of infection to watch for, and recommendations for activity restrictions to promote healing. The patient may also be advised on the importance of keeping the graft site clean and dry. Follow-up appointments are essential to assess the healing process and to ensure that the graft is integrating properly with the surrounding tissue. The expected recovery time may vary depending on individual factors, but patients can generally expect to see significant healing within a few weeks, with ongoing improvements in the appearance of the graft over time.
| Short Descr | FTH/GFT FR N/E/E/L 20 SQCM/< | Medium Descr | FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/< | Long Descr | Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5A - Ambulatory procedures - skin | MUE | 1 | CCS Clinical Classification | 172 - Skin graft |
This is a primary code that can be used with these additional add-on codes.
| 15261 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code 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) |
| 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | SG | Ambulatory surgical center (asc) facility service | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | LT | Left side (used to identify procedures performed on the left side of the body) | E2 | Lower left, eyelid | E4 | Lower right, eyelid | RT | Right side (used to identify procedures performed on the right side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | E1 | Upper left, eyelid | E3 | Upper right, eyelid | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure |
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| 2025-01-01 | Changed | Short Description punctuation changed. |
| 2024-01-01 | Changed | Short Description changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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