Rather, it is removal of devitalized tissue, necrosis, and slough by other methods, including: Examples of non-excisional debridement are pulsed lavage, mechanical lavage, mechanical irrigation, high-pressure irrigation, etc. For example, debridement of two ulcers on the foot to the level of subcutaneous tissue, total area of 6 sq cm should be billed as CPT code 11042 with unit of service of 1. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. hbbd``b`J@ H0lV$ W0 y Youre right about the skin graft code(s). Secondary Payor Doesnt Recognize Consultations. cm). culture and sensitivity), osteomyelitis (e.g. If there is not enough clarity, then a query would be indicated. KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. Terms: Primary intention means that the edges of the wound or graft are closed to allow them to grow together, while secondary intention refers to allowing an open wound to heal from the base up by building new tissue. Q&A: Billing for wound debridement and skin substitute application j0 W0 a$EdK@#)6e|y~#5H. MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. At a minimum, the Progress Report must document the continuing skilled assessment of wound healing as it has progressed since the evaluation or last Progress Report. Non-autologous human skin (dermal or epidermal, cellular and acellular) grafts, including allografts (from a person other than the patient) and homografts (from cadavers) HWAnl))1p9CK,q@:(#"ET.OSnt$v\^lt6btT 9A'w>$bg71w= Y)s.girVu^T_N'%u7Ag>f|vsQ lCN}uCjdgIKLYvO0>E,bRpUuCXX_"RkdEN""/@1] $' O*o5-OEJmq@Hc^VVl 0 If the wound is being excised, not just debrided, at the time of split thickness skin graft placement then you could also report a surgical preparation code (e.g., 15002, 15004) in addition to the skin graft code. cm involved a skin substitute application, you can report 15271 for the 20 sq. reasonable efforts to provide accurate coding information, this information should not be construed as providing clinical advice, dictating reimbursement policy, or substituting for the judgment of a practitioner. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. 0000004501 00000 n x-ray), and treatment of any infection by antibiotics. Applicable FARS\DFARS Restrictions Apply to Government Use. 15004 and +15005 for face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. You need to master the different graft options and know how to find the information in the surgeons note, because CPT includes different code sets for each type of graft. Please visit the. CMS believes that the Internet is When can I report a debridement in addition to a graft? Cornerstones of chronic foot ulcer management include relief of pressure, control of infection and appropriate debridement. For instance, Versajet debridement is considered to be nonsurgical, mechanical debridement because it does not involve cutting away or excising devitalized tissue. However, please note that once a group is collapsed, the browser Find function will not find codes in that group. Initial debridement may be deep and through skin, subcutaneous tissue, muscle fascia, and muscle. The skin substitute graft codes require some form of fixation, such as adhesives, sutures, or staples. Include simple debridement: Skin replacement grafts include simple debridement of granulation tissue or recent avulsion. 1253 0 obj <> endobj Billing and Coding for Skin Substitute Grafts In your case, the wound is being closed with a split thickness skin graft so the debridement codes are not accurate in this situation. Debridement is the removal of dead (necrotic) or infected skin tissue to help a wound heal. recipient email address(es) you enter. The objective of the procedure is to . Avoid: Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. Skin substitute grafts include the following: That means you should never report 97602 (Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session) in addition to skin graft site preparation codes. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential appropriate codes to use when performing a non-surgical application of a skin substitute. f-\n`Js^7u_p9X-WEpWio.@C6I@|V5J]5q;@OXAi*##C#YL,3+Ol]8t~{kR[.){l+-{AIe^\0(IA%ju~qy=(*FZ> l9a|ZJ>}*:2 {GI5|hV\)f#a43eEMM0s cm or less). Bilateral Carpal Tunnel Procedures Different Days, Multiple Laminectomies to Place a Spinal Cord Stimulator. Debridement services are now defined by body surface area of the debrided tissue and not by individual ulcers or wounds. 11010 Debridement including removal of foreign material associated with open fracture (s) and/or dislocation (s); skin and subcutaneous tissues. Please reference the CPT descriptions for application of skin substitutes codes (Attachment C). THE UNITED STATES To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom 0000044306 00000 n Addition to Skin Graft Codes. Is this right? Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. PDF Coding for Wound Care - apma.org The medical record should include the following information: The documentation must include that if indicated, ongoing pressure relief has been prescribed, for example, shoe inserts, modifications, padding, frequent position changes, etc. cm and not just that the size of the skin substitute was 20 sq. Q4*`F!PZuTA~}p?sB(C0qT, "~v6C[a]o]C%%=V 0000022753 00000 n 0000010407 00000 n iC>:D~c~V*H0"Q%L]5CB This Agreement will terminate upon notice if you violate its terms. This note should describe the anatomical location treated, the instruments used, anesthesia used if required, the type of tissue removed from the wound, the depth and area of the wound and the immediate post procedure care and follow-up instructions. Supportive Documentation Requirements (required at least every 10 visits) for 97597 and 97598: Medical records must be made available to Medicare upon request. These codes are primarily used when irrigation and . %PDF-1.7 % 0000020105 00000 n cm of the total 85.25 sq. A description of the tissue removed (e.g., necrotic, devitalized or non-viable) Size: To determine the surface area for code selection, add all areas within the same anatomic grouping, if the surgeon prepares multiple wounds. iv. authorized with an express license from the American Hospital Association. endstream endobj startxref 0000000936 00000 n *This response is based on the best information available as of 4/11/19. Draft articles have document IDs that begin with "DA" (e.g., DA12345). Continuation of treatment plan with ongoing evidence of the effectiveness of that plan, including diminishing area and depth of the ulceration, resolution of surrounding erythema and /or wound exudates, decreasing symptomatology, and overall assessment of wound status (such as stable, improved, worsening, etc). To participate in the NAHRI forum discussions, you must be a member of the NAHRI community. Skin substitute graft application code selection is based on defect site location and size. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, Answer: Coding for skin replacement surgery in 2012 | The Bulletin 11011 skin, subcutaneous tissue, muscle fascia and muscle. /| hb```b``Qg`e`y @16.5&Gsf cQ"b8)l82+q {5lJ,lhn7: YZGA 3*l910eX,_ ,*KodXD78^mc0[dzMBt Q4102 . Codify Subscriber Answer: You should [], Copyright 2023. Do you code debridement with skin graft? - Wise-Answer 0000010490 00000 n 0000036033 00000 n This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures. Dont report a skin substitute graft when the surgeon applies non-graft wound dressings such as gel, powder, ointment, foam liquid, or injected skin substitutes, according to the guidelines. Auto- is different: If you see the term autograft or tissue cultured autograft, then you are dealing with the harvest and/or application of an autologous skin graft. When other reconstructive procedure(s) (skin graft, myocutaneous flap, vessel graft . is needed for additional grafting, bill according to the number of single units of Apligraf, No. The views and/or positions Skin Substitute, Oasis wound Matrix, per square centimeter Copyright © 2022, the American Hospital Association, Chicago, Illinois. Follow our experts tips to make sure you select the proper code and get all the pay your surgeon deserves for these services. When can I report debridement separately? Remember that the debridement codes, 11042-11047, are reported when you debride an open wound that will stay open to heal by secondary intention. All Rights Reserved (or such other date of publication of CPT). View ICD-10-PCS CODING 2022 - Case Studies and Code Building Exercises.docx from HLTH 1241 at St. John's University. o Total site 100 sq cm or more: 15273 first 100 sq cm (or 1 percent body area infants and children); +15274 each additional 100 sq cm (or 1 percent body area infants and children), o Similar code pairs based on area: 15275 and +15276; 15277 and +15278. Your coder is correct simple debridement is included in the graft codes. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. Copyright 2023 HCPro, a Simplify Compliance brand. To code the excision, look in the index for the term Lesion, then Skin. KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. KarenZupko & Associates, Inc. 2023 | All Rights Reserved. 0000010293 00000 n Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. Question: Non-graft wound dressings or injected skin substitute codes are not used with skin replacement surgery application codes and are considered incorrect coding. o Similar code pairs based on area: 15275 and +15276; 15277 and +15278 of the Medicare program. Sign up to get the latest information about your choice of CMS topics in your inbox. Would also adding Mod 22 help, and for which one 11042 or 11043? cm. Debridement Prior to Skin Grafting - KarenZupko&Associates, Inc. Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; HLN>bE+hAi .xiJ2D4>"A_6N@f("nChK!`=x;c` DIS!Sf8_c^x)$ He is an alumnus of York College of Pennsylvania and Clemson University. The following procedures are considered part of active wound care management, and are not considered as debridement and are not included in the related LCD: Removal of devitalized tissue from wound(s), non - selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care. What does Separate Procedure Mean in a CPT Code Description? and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only My plastic surgeon debrided an open burn wound that was 45 sq cm then placed a split thickness skin graft over the wound. Frequent skilled observation and assessment of wound healing are recommended daily or weekly to justify the skilled service. If the provider is unable to use photographs for documentation purposes, the medical record should contain sufficient detail to determine the extent of the wound and the result of the treatment. You can use the Contents side panel to help navigate the various sections. endstream endobj startxref The National Correct Coding Initiative (NCCI) bundles skin substitute graft codes 15271-+15277 with skin and subcutaneous debridement code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less). Secondary Payor Doesnt Recognize Consultations. The procedure is essential for wounds that aren . While every effort has been made to provide accurate and Include cleaning: When the surgeon performs a simple cleansing of the wound, that service is included within the skin substitute procedure codes, according to CPT instruction. Terms: Primary intention means that the edges of the wound or graft are closed to allow them to grow together, while secondary intention refers to allowing an open wound to heal from the base up by building new tissue. 0000008214 00000 n Tech & Innovation in Healthcare eNewsletter, Excision of Benign or Malignant Skin Lesion, Reporting Debridement Requires Documented Area and Depth, Both Depth and Area Matter when Reporting Debridement, Meet Documentation Criteria for Excisional Debridement, subcutaneous tissue (includes epidermis and dermis, if performed) 11042, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed) 11043, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed) 11044. In most instances Revenue Codes are purely advisory. If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. Please subscribe today or login for access. That means you should select the appropriate HCPCS Level II code such as Q4101 (Apligraf, per square centimeter) or C1763 (Connective tissue, non-human (includes synthetic)) for the graft material. Photographic documentation of wounds either immediately before or immediately after debridement is recommended for prolonged or repetitive debridement services (especially those that exceed five extensive debridements per wound (CPT code 11043 and/or 11044)). Application of Bioengineered Skin Substitutes and Skin Grafting is performed on ulcers that are free of . American Hospital Association ("AHA"), Reader Question: Distinguish Additional Lesion Excision Method, CCI Edits: Navigate Surgery Bundles That Could Compromise Your Pay, ICD-10 Changes: Master Guidelines for Infection, Sepsis. hUmo0+q 0HUmIkN^D Wk$$[n;=AIWq@ These materials contain Current Dental Terminology (CDTTM), copyright© 2022 American Dental Association (ADA). Add together the surface area of multiple . Integumentary Procedures: 3 Tips Guide Coding for Skin Substitute Grafts, 3 Tips Guide Coding for Skin Substitute Grafts, Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (, 15002 and +15003 for trunk, arms, legs (including wrist or ankle), 15004 and +15005 for face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, Non-autologous human skin (dermal or epidermal, cellular and acellular) grafts, including allografts (from a person other than the patient) and homografts (from cadavers), Non-human skin substitute grafts such as xenografts (from another animal such as pig), Biological products that form a sheet scaffolding for skin growth. 3]HE1}}&Z\d3aD)6C~NYZgois\t-w;s3N>dgp@GtBisMaq)%le"Z\g.j4 9qEb*NLaQD\/z a\)DC|[JkHHq\J.d&X. You can collapse such groups by clicking on the group header to make navigation easier. In addition to the type of graft material, the surgeon should also document site preparation and wound size, and number and location of grafts, according to Beresh. For example: Bone is debrided from a 4 sq cm heel ulcer and from a 10 sq cm ischial ulcer. Per the MFSDB - payment for bilateral procedures does not apply. The page could not be loaded. |S=LqO=Vz Answer: Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contractures ). In addition to the type of graft material, the surgeon should also document site preparation and wound size, and number and location of grafts, according to Beresh. As used herein, "you" and "your" refer to you and any organization on behalf of which you are acting. Biological implants Size: To determine the surface area for code selection, add all areas within the same anatomic grouping, if the surgeon prepares multiple wounds. Subsequent debridement is often more superficial and best described by CPT codes 97597 or 97598 rather than 11043 or 11044. Copyright 2023, AAPC The National Correct Coding Initiative (NCCI) bundles skin substitute graft codes 15271-+15277 with skin and subcutaneous debridement code 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less). If you miss the separate skin preparation step, youll sacrifice pay your surgeon deserves. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Im looking at getting 11042 (debridement) and the skin graft codes precertified. In CPT, coding these grafts by size is a novel concept. uKEmc2vy5\^gB:w76>9s=gKn4"=yJ} crv[d[ ML\:6q~6U6_Nc8Dc?nN8^>\RY[qZ{XO*JT!e,(7=m]7}}O@gSS(B"t658>~.%W['i9hch8bQT%ml and Full Thickness Skin Grafts Code range for STSG -15100 (Trunk, arms and legs) -15120 (Face, scalp, eyelids, mouth, neck, ears . The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or This question was answered by Denise Williams, COC, senior vice president of the revenue integrity division and compliance auditor at Revant Solutions in Trussville, Alabama. Skin replacement surgery consists of two basic steps: surgical preparation of the recipient site and placement of the graft with fixation. Skin Lesion Excision Wait for Pathology? application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) an effective method to share Articles that Medicare contractors develop. Anesthesia administered by or incident to the provider performing the debridement procedure is not separately payable. 0000012252 00000 n To report these codes, the surgeons documentation should demonstrate work such as removing nonviable tissue and/or releasing a scar contracture. Instructions for enabling "JavaScript" can be found here. H|Wd5W5Re'c X!XFk4K|?>_/]%zWCBJ7 .`u}}`JWJz=^o\z9e~BT AT9 vqdYkh%BprY-.%V)["[n . I96w4Ak1;*8LMZI;Oe1\s &$W2DQY#"E"2$*85lm"HIl]JW)"4#F3^6F8?1HtaG]xuA*D::!83P|MnKC*{:?qk,nlG,d=atI'0 I2nC CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. When the patient has required more debridement services per wound than defined below, the medical record must include documentation reflecting neuropathic, vascular, metabolic, or other comorbid conditions. cm of the total 85.25 sq. If the surgeon leaves the wound open, you will report a debridement (11040-11044) rather than an excision. This email will be sent from you to the *4 Use CPT code 15340-15341 or CPT code 15360-15366 for the surgical preparation or creation of recipient site for the tissue skin graft. twZ5C2ayV`C~1S6#9mOk)d4sr$#yd:W8 Eu1EgZ \ 0 E endstream endobj 49 0 obj <>stream hVmo6+ER|l%v5/:Bm#e'b|x;CA\X&V@[ ElBdd B()"8$^DHhFTDv):7^L]c"BJ#=,'$T#BJ! Be sure that the documentation supports that the wound area covered by the skin substitute was 20 sq. Medicaid and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration cm. Code Debridement by Documented Depth and Area When reporting debridement of a bedsore, code selection depends on the depth of debridement and total area debrided: Depth to subcutaneous tissue (to the depth of blood vessels and nerves): 11042 (first 20 sq cm) and +11045 (each additional 20 sq cm, or part thereof) R'7bd snYJ@ 9PE@ cL endstream endobj 44 0 obj <>>> endobj 45 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Tabs/W/Thumb 35 0 R/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 46 0 obj [/ICCBased 68 0 R] endobj 47 0 obj <> endobj 48 0 obj <>stream Determining the wound location and surface area is important in order to select the appropriate CPT code. Article document IDs begin with the letter "A" (e.g., A12345). 15002 and +15003 for trunk, arms, legs (including wrist or ankle) Some articles contain a large number of codes. This article was converted to the new Billing and Coding Article format. CPT is a trademark of the American Medical Association (AMA). Appropriate changes in the ongoing treatment plan to reflect the clinical presentation must be present in the record. The surgeon may choose to leave the wound open in anticipation that healthy tissue will grow over the ulcer site. 465 Wound Debridement and Skin Graft Except Hand, for Musculo-Connective Tissue Disorders without CC/MCC 573 Skin Graft for Skin Ulcer or Cellulitis with MCC The Medicare program provides limited benefits for outpatient prescription drugs. 0000017393 00000 n PDF Billing and Coding Guidelines: Contractor Name - Centers for Medicare hb```f``e`2jx Y8t00:00@9@ 6 jx You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. 39 0 obj <>stream Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). The patient's medical record must contain documentation that fully supports the medical necessity for services included withinthe related LCD. Federal government websites often end in .gov or .mil. Medicare contractors are required to develop and disseminate Articles. cm and then debridement codes (with an appropriate modifier) for the remaining 65 sq. Remember that the debridement codes, 11042-11047, are reported when you debride an open wound that will stay open to heal by secondary intention. In your case, the wound is being closed with a split thickness skin graft so the debridement codes are not accurate in this situation. This code is based on a wound size (singular or aggregate size; after cleansing, prepping, and/or debriding) minimally of 100 sq cm*. Debridement: Types, Recovery, Complications & More - Healthline You will see two additional references: benign and malignant. CMS and its products and services are not endorsed by the AHA or any of its affiliates. Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. There are multiple ways to create a PDF of a document that you are currently viewing. CPT codes 11000 and 11001 describe removal of extensive eczematous or infected skin. Question: 1309 0 obj <>stream Not exactly. cm or less). 0000015008 00000 n Examples of the inappropriate use of these codes are ulcers, furuncles, and localized skin infections. 2021 Evaluation and Management Codes: Is a History Required? PDF DermaSpanTM Acellular Dermal Matrix Coding Reference Guide - Zimmer Biomet Whether the surgeon performs both steps at a single encounter or delays grafting for a later time, report the surgical preparation using codes in the range 15002-+15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contractures ). without the written consent of the AHA. Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. PDF Billing and Coding Guidelines - Centers for Medicare & Medicaid Services Autologous skin grafts are those that the surgeon harvests from another healthy part of the patients own body, and you would use different codes for those graft procedures. 0000002478 00000 n KarenZupko & Associates, Inc. | 312.642.5616 | information@karenzupko.com. The AMA is a third party beneficiary to this Agreement. There are lessons to be learned to avoid damaging coding habits. qe<>O &j'>-3c\BMAi`/@SPPkS u6X \[bkjqkXdV41+ahqg& _p,d4ueQ@Ha s0O (See "Indications and Limitations of Coverage.") You can still separately code for deep debridement that includes muscle and bone, says Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington, using a code such as 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq. That means you should select the appropriate HCPCS Level II code such as Q4101 (Apligraf, per square centimeter) or C1763 (Connective tissue, non-human (includes synthetic)) for the graft material. Report these procedures, when they represent covered, reasonable and necessary services, using the CPT or HCPCS code that most closely describes the service rendered. An asterisk (*) indicates a 0000006836 00000 n 0000018702 00000 n The views and/or positions presented in the material do not necessarily represent the views of the AHA. 2. Distinguish the codes based on body site, as follows: Each pair of codes identifies the size of the defect created by the surgical preparation, with the first code (15002 or 15004) describing the first 100 sq cm for adults and children aged 10 and up, or 1 percent of body surface area for children under 10 years of age, including infants. Debridement is generally associated with injuries, infections, wounds, and/or ulcers. Replacement material, graft size, multiple wounds all these factors and more will come into play when youre coding a skin replacement surgery using skin substitute grafts for conditions such as burns. Youve learned that you can separately report the site preparation and the skin substitute graft placement procedures, but you may wonder what other services and materials in the op report are separately billable.
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