CPT® Code 15330 | Case2Code

Code deleted, see 15271-15274

Official Description

Acellular dermal allograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

Common Language Description

An acellular dermal allograft is a specialized type of skin graft utilized to cover skin defects located on the trunk, arms, or legs. This graft is derived from cadaveric skin that has undergone a chemical treatment process to remove the epidermal cellular components, which are responsible for triggering immune responses. By eliminating these antigenic components, the likelihood of the graft being rejected by the recipient's immune system is significantly reduced. Initially developed for the treatment of burn victims, acellular dermal allografts have expanded in application to include reconstructive surgery, dental and oral procedures, as well as various plastic and cosmetic surgeries. The procedure involves the careful preparation of the graft, which is typically packaged in sheets. These sheets are rehydrated using an isotonic sodium chloride solution to restore their pliability before being trimmed to fit the specific dimensions of the wound. Once prepared, the graft is applied to the cleaned and prepared wound bed, either in a single layer or multiple layers, and is secured in place with absorbable sutures. Any excess material around the edges of the wound is trimmed to ensure a proper fit. Additionally, the graft may be covered with a separately reportable skin flap if necessary. After the graft is in place, a layered dressing is applied, which includes a bulky gauze layer, a compression layer, and an anti-shear layer to protect the graft and promote healing. The CPT® Code 15330 is specifically designated for the first 100 square centimeters of grafting in adults or for 1% of total body surface area in infants and children, while 15331 is used for each additional 100 square centimeters or 1% of total body surface area thereafter.

1. Indications

The acellular dermal allograft procedure is indicated for various conditions and situations where skin coverage is necessary. The following are the explicitly provided indications for this procedure:

Skin Defects The procedure is performed to cover skin defects located on the trunk, arms, or legs.
Burn Treatment Initially used for treating burn patients, this graft is suitable for areas requiring skin restoration after severe burns.
Reconstructive Surgery It is indicated for reconstructive procedures where skin coverage is essential for restoring the integrity of the skin.
Dental and Oral Procedures The graft can be utilized in dental and oral surgeries that require soft tissue coverage.
Plastic and Cosmetic Procedures It is also indicated for various plastic and cosmetic surgeries that necessitate skin grafting for aesthetic or functional purposes.

2. Procedure

The procedure for applying an acellular dermal allograft involves several detailed steps, which are outlined as follows:

Preparation of the Graft The acellular dermal allograft is initially packaged in sheets. These sheets are rehydrated in an isotonic sodium chloride solution to restore their flexibility and usability for the procedure.
Trimming the Graft After rehydration, the graft sheets are trimmed to the appropriate dimensions to fit the specific size and shape of the wound being treated.
Application of the Graft The trimmed graft is then applied over the prepared wound bed. This can be done in either a single layer or multiple layers, depending on the requirements of the wound.
Securing the Graft The graft is secured in place using absorbable sutures, ensuring that it adheres properly to the wound bed and remains in position during the healing process.
Trimming Excess Graft Any excess material at the periphery of the wound is carefully trimmed to ensure a neat and effective fit of the graft.
Covering the Graft If necessary, the acellular dermal allograft layers may be covered with a separately reportable skin flap to provide additional protection and support.
Applying Dressings Finally, a layered dressing is applied over the graft. This dressing typically includes a bulky layer of gauze, a compression layer, and an anti-shear layer to protect the graft and facilitate optimal healing.

3. Post-Procedure

Post-procedure care for patients receiving an acellular dermal allograft involves monitoring the graft site for signs of infection and ensuring that the dressing remains intact. Patients are typically advised to keep the area clean and dry, and to follow specific instructions regarding activity restrictions to promote healing. Regular follow-up appointments may be necessary to assess the graft's integration and healing progress. Any concerns regarding the appearance or condition of the graft should be addressed promptly with the healthcare provider to ensure optimal outcomes.

Short Descr	APLY ACELL ALOGRFT T/ARM/LEG
Medium Descr	ACLR DERMAL ALLOGRAFT TRUNK/ARM/LEG 1ST 100 CM
Long Descr	Acellular dermal allograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
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