Skin Grafts

by  Find-A-Code™
Jan 1st, 2019 - Reviewed/Updated Apr 22nd

Skin grafts are used when natural healing or simple closure isn’t enough, especially for large, deep, or non-healing wounds. The following are some common reasons why a skin graft may be used:

• Large wounds or tissue loss (trauma, accidents)
• Severe burns
• Chronic wounds (e.g., diabetic foot ulcers, venous ulcers)
• After removal of skin cancer (like melanoma or other lesions) Infections that destroy skin (after debridement)
• Surgical wounds that cannot be closed primarily
• Areas needing functional or cosmetic reconstruction

Billing for these services requires reporting both the applicable CPT procedure code and a HCPCS supply code. The following are some procedure code options:

• Autografts:
  • Dermal (15130, 15131, 15135, 15136)
  • Epidermal (15110, 15111, 15115,15116)
  • Soft Tissue (15769)
  • Split-thickness (15100, 15101, 15120, 15121)
  • Tissue Cultured (15150, 15151, 15152, 15155, 15156,15157)
• Full thickness grafts, free (15200, 15201, 15220, 15221, 15240, 15241, 15260, 15261)
• Surgical preparation or creation of recipient site (15002, 15003, 15004, 15005)

Skin Graft Coding Tips

• Claims reporting skin substitutes (e.g., HCPCS codes beginning with either an A or a Q) must be billed in conjunction with an appropriate application code (15271-15278). Just search on the product name to find the HCPCS supply code.
  
  
• When reporting an ulcer due to diabetes, report the diabetes with a foot ulcer code first (e.g., E08.621) followed by the applicable ulcer code (e.g., L97.4-, L97.5-).
  
  
• For Medicare, refer to Local Coverage Determinations (LCDs) and Articles for more information about their specific requirements. When viewing the code on FindACode.com, just click on the blue bar titled “Medicare Policies & Guidelines” listed under the code.

Skin Graft Diagnoses Codes

Consider ICD-10 codes from the following:

E08.621  Diabetes mellitus due to underlying condition with foot ulcer
E09.621  Drug or chemical induced diabetes mellitus with foot ulcer
E10.621  Type 1 diabetes mellitus with foot ulcer
E11.621  Type 2 diabetes mellitus with foot ulcer
E13.621  Other specified diabetes mellitus with foot ulcer
I83.0-     Varicose veins of lower extremities with ulcer
I83.2-     Varicose veins of lower extremities with both ulcer and inflammation
I87.01-  Postthrombotic syndrome with ulcer
I87.03-  Postthrombotic syndrome with ulcer and inflammation
I87.31-  Chronic venous hypertension (idiopathic) with ulcer
I87.33-  Chronic venous hypertension (idiopathic) with ulcer and inflammation

For skin graft complications consider these:

T86.820 Skin graft (allograft ) rejection
T86.821 Skin graft (allograft ) (autograft ) failure
T86.822 Skin graft (allograft ) (autograft ) infection
T86.828 Other complications of skin graft (allograft ) (autograft )
T86.829 Unspecified complication of skin graft (allograft ) (autograft )