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Laureen: Q: Skin substitute question. How would you report the application of a 5 sq. cm. skin substitute to the right index finger, 6 sq. cm. skin substitute to the left thumb, and a 15 sq. cm. skin substitute to the right foot?

Let’s see what we work up here… This looks like someone had like a practice question and they weren’t agreeing with the answers, so they provided us with the potential answers, and I have a feeling the issue was that there’s a typo here because you’ll notice “a” and “d” are exactly the same. So she said 15275 was identified as the correct answer, I don’t see how this coincide with the description.

A: This is what I did, I went and I pulled up 15275 and 276; the 275 is for the first 25 sq.cm, and the 276 is for each additional or part thereof. I’m so glad they finally added that language to CPT for these.

Medical Coding for Skin Substitute – Video

When we break it down, we’ve got 5 sq.cm. right index; 6 sq.cm. left thumb; 15 sq.cm. right foot. These all fit the description of 15275 as far as the body areas go, because this is face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. So we had digits and we had a foot, so they do all belong on the same grouping, so we need to figure out our measurement. Are we 25 sq. cm. or less? Are we more than that?

When we add it up, it comes to 26 sq.cm. Hope we have our math checkers. Yes, 26. So, you’re going to have one unit of 15275 for the 25 sq.cm; and you’re allowed to bill, believe it or not, a 15276 because there’s that one extra sq. cm. Because in the description it says, “or part thereof” that’s your permission slip, so to speak, to be able to code that add-on code 15276.

You’re correct that there was no correct answer here, so I would have made this 15276 and that would have made “d” the correct answer if they have done that. So, I think it was just a typo in the practice exam. And if it’s one of ours, please email helpdesk@.

Find out More about Medical Coding for Skin Substitute

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2016-11-20T23:37:58+00:00

About the Author:

Laureen Jandroep
CPC, COC, CPPM, CPC-I.,Sr. Instructor for CCO.us. Resides in southern New Jersey with her husband of over 20 years Anthony and four children. They are active parents and spend most of their time these days just being parents which they love.

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