“Spotlight on CPT” is covering a new series of CPTs this month pertaining to skin cell suspension autografts (SCSA). In the Integumentary System section, there is a new subsection under Skin Replacement Surgery entitled Skin Cell Suspension Autograft. This new code range spans codes 15011-15018.
SCSA is a procedure that involves harvesting skin and then creating a of suspension of autologous skin cells which can then be sprayed directly on wounds to facilitate healing. The types of wounds that could be treated are varied and include burns, avulsions, or wounds resulting from treatment by excision/resection as in the case of skin cancer.
The new CPT codes that have been created cover the different steps of the SCSA process. Codes 15011 and add-on code 15012 cover the initial phase of treatment where the skin is harvested. Code assignment should be based on the number of square centimeters harvested with 15011-harvest of skin for skin cell suspension autograft; first 25 sq. cm. or less and code +15012-each additional 25 sq. cm. or part thereof. There are several points to make with these codes. First, 25 sq. cm. may seem like a small amount of skin to harvest, however, coding professionals should know that there is an approximate expansion ratio of 1:80. What this means is when 25 sq. cm. of skin is harvested, the return will be about 2,000 sq. cm. Also, it is important to point out with the phrase “or part thereof” in code +15012, it means exactly that. There is no proscribed threshold of the 25 sq. cm. that must be obtained to assign the add-on code. So, if 37 sq. cm. were harvested assign 15011 and 15012 (for the extra 12 sq. cm.) and if 25.1 sq. cm. were harvested, assign the same codes. The .1 sq. cm. count as “part thereof”.
The next two codes, 15013 and 15014 address the preparation of the skin cell suspension autograft. This process requires enzymatic processing, manual mechanical disaggregation of skin cells, and filtration, and once again based on the 25 sq. cm. of harvested skin. Same note about to account for +15014 “or part thereof” phrase as previously discussed for +15012. Another point to note for these codes is that the skins cells must be processed manually to use the codes. If automation is used for the processing do not report 15013 or 15014.
The last four new codes (15015, 15016, 15017, 15018) all address the application of the SCSA. There are several distinctions to make here. First, these codes address application of the graft to wound and donor sites and are based on the first 480 sq. cm. or less (15015, 15017) or to each additional 480 sq. cm. or part thereof. Same reminder about “part thereof” as mentioned earlier. Next, these codes are differentiated by the body part being treated. Codes 15015 and +15016 apply to treatment of the trunk, arms, or legs, while codes 15017 and +15018 apply to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. All these codes include any dressing that is applied primarily which is inclusive of its means of fixation including sutures, staples, or surgical glue).
Just a few other notes regarding SCSA coding. If there is donor site repair with skin grafts or flaps, these may be separately coded. These separate autografts could include split-thickness or full-thickness autografts. Additionally, if separate autografts are placed before the SCSA, these, too, may be separately coded. And finally, if there is recipient site surgical preparation before SCSA it may also be separately coded.
SCSA is a procedure that involves harvesting skin and then creating a of suspension of autologous skin cells which can then be sprayed directly on wounds to facilitate healing. The types of wounds that could be treated are varied and include burns, avulsions, or wounds resulting from treatment by excision/resection as in the case of skin cancer.
The new CPT codes that have been created cover the different steps of the SCSA process. Codes 15011 and add-on code 15012 cover the initial phase of treatment where the skin is harvested. Code assignment should be based on the number of square centimeters harvested with 15011-harvest of skin for skin cell suspension autograft; first 25 sq. cm. or less and code +15012-each additional 25 sq. cm. or part thereof. There are several points to make with these codes. First, 25 sq. cm. may seem like a small amount of skin to harvest, however, coding professionals should know that there is an approximate expansion ratio of 1:80. What this means is when 25 sq. cm. of skin is harvested, the return will be about 2,000 sq. cm. Also, it is important to point out with the phrase “or part thereof” in code +15012, it means exactly that. There is no proscribed threshold of the 25 sq. cm. that must be obtained to assign the add-on code. So, if 37 sq. cm. were harvested assign 15011 and 15012 (for the extra 12 sq. cm.) and if 25.1 sq. cm. were harvested, assign the same codes. The .1 sq. cm. count as “part thereof”.
The next two codes, 15013 and 15014 address the preparation of the skin cell suspension autograft. This process requires enzymatic processing, manual mechanical disaggregation of skin cells, and filtration, and once again based on the 25 sq. cm. of harvested skin. Same note about to account for +15014 “or part thereof” phrase as previously discussed for +15012. Another point to note for these codes is that the skins cells must be processed manually to use the codes. If automation is used for the processing do not report 15013 or 15014.
The last four new codes (15015, 15016, 15017, 15018) all address the application of the SCSA. There are several distinctions to make here. First, these codes address application of the graft to wound and donor sites and are based on the first 480 sq. cm. or less (15015, 15017) or to each additional 480 sq. cm. or part thereof. Same reminder about “part thereof” as mentioned earlier. Next, these codes are differentiated by the body part being treated. Codes 15015 and +15016 apply to treatment of the trunk, arms, or legs, while codes 15017 and +15018 apply to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. All these codes include any dressing that is applied primarily which is inclusive of its means of fixation including sutures, staples, or surgical glue).
Just a few other notes regarding SCSA coding. If there is donor site repair with skin grafts or flaps, these may be separately coded. These separate autografts could include split-thickness or full-thickness autografts. Additionally, if separate autografts are placed before the SCSA, these, too, may be separately coded. And finally, if there is recipient site surgical preparation before SCSA it may also be separately coded.
Now, light has been shed on coding skin cell suspension autografts.
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