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The procedure described by CPT® Code 15040 involves the harvesting of skin from a patient for the purpose of creating a tissue cultured skin autograft. This process is particularly relevant for patients suffering from extensive burns, specifically those with burns that cover 30% or more of their total body surface area (TBSA). The harvested skin, which is limited to an area of 100 square centimeters or less, is critical for the subsequent development of skin grafts that can be applied to the affected areas. During the procedure, a dermatome—a specialized surgical instrument—is utilized to obtain a thin layer of skin. To minimize bleeding during the harvesting process, the subcutaneous tissue is infiltrated with a solution that contains epinephrine. Once the skin is harvested, it is sent to a specialized laboratory where the epithelial cells are separated from the dermal cells. These cells are then placed in an incubator and provided with the necessary nutrients to promote growth, allowing them to develop into sheets of skin suitable for grafting. Additionally, the dermal cells may also be cultured, and the layers of cells can be combined before they are grafted onto the burn sites, enhancing the potential for successful healing and recovery.
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The harvesting of skin for tissue cultured skin autograft, as described by CPT® Code 15040, is indicated for patients with significant burn injuries. Specifically, this procedure is performed on individuals who have burns covering 30% or more of their total body surface area (TBSA). The need for skin grafting arises from the requirement to cover large areas of damaged skin to promote healing and restore the integrity of the skin barrier.
The procedure for harvesting skin for tissue cultured skin autograft involves several critical steps to ensure the successful collection and preparation of skin for grafting.
Post-procedure care following the harvesting of skin for tissue cultured skin autograft is essential for ensuring optimal healing and preparation for grafting. The harvested area will require monitoring for signs of infection and proper wound care to promote healing. The patient may also need to follow specific instructions regarding activity restrictions and care of the donor site. Once the cultured skin is ready, further procedures will be scheduled to apply the grafts to the burn areas, which will also require careful post-operative management to ensure successful integration and healing of the grafts.
| Short Descr | HARVEST CULTURED SKIN GRAFT | Medium Descr | HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/< | Long Descr | Harvest of skin for tissue cultured skin autograft, 100 sq cm or less | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 172 - Skin graft |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | E1 | Upper left, eyelid | E3 | Upper right, eyelid | E4 | Lower right, eyelid | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2006-01-01 | Added | First appearance in code book in 2006. |
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