CPT® Code 15320 | Case2Code

Code deleted, see 15275-15278

Official Description

Allograft skin for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

Common Language Description

A skin allograft is a medical procedure that involves the application of donor skin to specific areas of the body, including the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, for the purpose of temporary wound closure. This procedure is particularly beneficial for patients suffering from extensive burns or other significant skin loss, where the availability of the patient's own skin (autogenous skin) is insufficient to cover the affected areas. The primary function of a temporary skin allograft is to provide a protective covering over the wound, which not only absorbs drainage but also prevents the wound from drying out, thereby promoting a conducive environment for healing. These allografts are typically split-thickness skin grafts that are harvested from cadaver donors and are cryopreserved until they are required for use. When needed, the allograft is carefully thawed and prepared for grafting onto the wound bed. The application process involves securing the allograft with absorbable sutures to ensure it remains in place. Following the graft application, a layered dressing is applied, which includes a nonadherent layer to protect the graft, a bulky layer of gauze for cushioning, a compression layer to minimize swelling, and an anti-shear layer to prevent friction. The CPT® Code 15320 is designated for the use of the first 100 square centimeters of allograft skin in adults or for 1% of the total body surface area (TBSA) in infants and children, while additional areas are coded with CPT® Code 15321.

1. Indications

The procedure of applying an allograft skin for temporary wound closure is indicated for patients with extensive skin loss due to various conditions. The following are specific indications for this procedure:

Extensive Burns Patients with significant burn injuries where there is inadequate autogenous skin available for wound coverage.
Skin Loss from Trauma Individuals who have experienced severe skin loss due to traumatic injuries that compromise the integrity of the skin.
Chronic Wounds Patients with chronic wounds that require temporary coverage to facilitate healing and protect the underlying tissue.

2. Procedure

The procedure for applying an allograft skin for temporary wound closure involves several critical steps, each designed to ensure the successful application and integration of the graft.

Preparation of the Wound Bed The first step involves thorough cleaning and debridement of the wound bed to remove any necrotic tissue and prepare the area for grafting. This ensures that the allograft will adhere properly and that the underlying tissue is healthy enough to support healing.
Thawing and Preparing the Allograft The allograft skin, which has been cryopreserved, is then carefully thawed according to established protocols. Once thawed, the allograft is inspected for quality and prepared for application, ensuring it is the appropriate size and shape for the wound.
Application of the Allograft The thawed allograft is placed onto the prepared wound bed. It is secured in position using absorbable sutures, which will dissolve over time and do not require removal. This step is crucial for ensuring that the graft remains in place during the initial healing phase.
Dressing the Graft After the allograft is secured, a layered dressing is applied. This dressing typically consists of a nonadherent layer to protect the graft, a bulky layer of gauze to provide cushioning, a compression layer to minimize swelling, and an anti-shear layer to prevent friction and movement that could displace the graft.

3. Post-Procedure

Post-procedure care is essential for the successful integration of the allograft and involves monitoring the graft site for signs of infection, proper adherence, and healing. Patients are typically advised to keep the area clean and dry, and to follow specific instructions regarding dressing changes. Regular follow-up appointments are necessary to assess the healing process and to determine if further interventions are required. The expected recovery time may vary depending on the extent of the wound and the patient's overall health, but the temporary allograft is designed to provide coverage until the patient's own skin can regenerate or until a more permanent solution can be implemented.

Short Descr	APPLY SKIN ALLOGRFT F/N/HF/G
Medium Descr	ALGRFT TEMP CLOSURE F/S/N/H/F/G/M/D 1ST 100CM
Long Descr	ALGRFT TEMP CLOSURE F/S/N/H/F/G/M/D 1ST 100CM
Status Code	Active Code
Global Days	090 - Major Surgery
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	2 - Standard 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	Discontinued Code
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	172 - Skin graft