CPC CPT Surgery: Integumentary System 3 — Questions and Answers
Question 1: Which CPT code is reported for a split-thickness skin graft covering 50 sq cm on the thigh of an adult?
- 15100 (Correct answer)
- 15120
- 15200
- 15220
Correct answer: 15100
CPT 15100 is reported for a split-thickness autograft to the trunk, legs, or arms for the first 100 sq cm in adults.
Question 2: An adjacent tissue transfer (Z-plasty) is performed to repair a defect of 12 sq cm on the trunk. Which CPT code applies?
- 14000 (Correct answer)
- 14020
- 14040
- 14060
Correct answer: 14000
CPT 14000 covers adjacent tissue transfer or rearrangement on the trunk for defects up to 10 sq cm, but 14020 covers trunk defects of 10.1 to 30.0 sq cm — the correct code here is 14020.
Question 3: Which of the following statements about skin substitute graft codes is correct?
- They are reported based on the number of layers applied
- They are reported based on the anatomic site and size of the recipient area in sq cm (Correct answer)
- They are always reported with the autograft code for the same site
- They are only reported when used as a temporary wound covering
Correct answer: They are reported based on the anatomic site and size of the recipient area in sq cm
Skin substitute graft codes (e.g., Apligraf, Dermagraft) are selected by anatomic site and recipient area size in square centimeters.
Question 4: A pedicle flap is delayed in preparation for a later transfer. How is this service reported?
- It is included in the final transfer code and not separately reported
- Report the delay procedure with code 15620 (Correct answer)
- Report using the appropriate tissue transfer code with modifier -52
- Report using the formation code and add modifier -58 for staged procedure
Correct answer: Report the delay procedure with code 15620
CPT 15620 (delay of flap or sectioning of pedicle) is reported when a pedicle flap is delayed prior to its definitive transfer.
Question 5: When reporting a full-thickness skin graft to the face, what is measured to determine the correct CPT code?
- The size of the donor site only
- The size of the recipient defect in square centimeters (Correct answer)
- The combined area of donor and recipient sites
- The linear measurement of the longest defect dimension
Correct answer: The size of the recipient defect in square centimeters
Full-thickness skin graft codes are selected based on the size of the recipient defect, not the donor site.
Question 6: Code 15002 is reported for surgical preparation of which type of wound?
- Chronic wound bed preparation by a specialist
- First 100 sq cm of burn wound excision in adults
- Recipient-site preparation for skin substitute grafts on trunk/arms/legs, first 25 sq cm (Correct answer)
- Simple debridement of a pressure ulcer
Correct answer: Recipient-site preparation for skin substitute grafts on trunk/arms/legs, first 25 sq cm
CPT 15002 covers recipient-site surgical preparation for skin grafts on the trunk, arms, or legs for the first 25 sq cm.
Question 7: When a free flap requires microvascular anastomosis, which add-on code is also reported?
- 15758
- 15777
- 15769
- 69990 (Correct answer)
Correct answer: 69990
CPT 69990 (microsurgical techniques, requiring use of operating microscope) is reported as an add-on when microvascular anastomosis is performed with a free flap.
CPC CPT Surgery: Integumentary System 3
Which CPT code is reported for a split-thickness skin graft covering 50 sq cm on the thigh of an adult?