CPT® Code 15421 | Case2Code

Code deleted, see 15275-15278

Official Description

Xenograft skin (dermal), for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Common Language Description

A dermal xenograft is a specialized medical procedure involving the application of skin tissue obtained from another species, typically porcine (pig), to facilitate temporary wound closure. This procedure is particularly relevant for areas of the body that require careful attention, such as the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and multiple digits. The xenograft serves as a biological dressing, providing a protective layer over the wound while promoting healing until it is eventually rejected by the patient's immune system. The skin graft is processed through methods such as glycerol treatment and freezing with liquid nitrogen or lyophilization (freeze-drying), which preserves the tissue for later use. When the graft is needed, it is either thawed or rehydrated before being meticulously applied to the prepared wound bed and secured in place, often with sutures. This procedure is coded under CPT® Code 15421, which is specifically designated for each additional 100 square centimeters of xenograft applied beyond the initial 100 square centimeters or 1% of total body surface area (TBSA) in infants and children. It is important to note that this code is used in conjunction with CPT® Code 15420, which covers the first 100 square centimeters or less in adults or the first 1% of TBSA in infants and children.

1. Indications

The procedure involving the application of a dermal xenograft is indicated for various conditions that necessitate temporary wound closure. These indications include:

Wound Management The procedure is performed to manage complex wounds that require a biological dressing to promote healing and protect the underlying tissue.
Burns It is indicated for patients with burn injuries where skin grafting is necessary to cover the affected areas and facilitate recovery.
Trauma The procedure is applicable in cases of traumatic injuries that result in significant skin loss, requiring temporary coverage until definitive surgical repair can be performed.
Chronic Ulcers It is also indicated for chronic wounds or ulcers that have not responded to conventional treatments and require advanced wound care techniques.

2. Procedure

The procedure for applying a dermal xenograft involves several critical steps to ensure effective wound closure and healing. These steps include:

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 graft application. This is essential to promote adherence and reduce the risk of infection.
Selection and Preparation of the Xenograft The appropriate size of the xenograft is selected based on the dimensions of the wound. If the graft has been frozen, it is thawed using a controlled method, or if it has been lyophilized, it is rehydrated to restore its pliability and functionality.
Application of the Xenograft Once prepared, the xenograft is carefully placed over the wound bed. It is crucial to ensure that the graft adequately covers the entire wound area to provide effective protection and promote healing.
Securing the Graft The xenograft is then secured in place, typically using sutures or other fixation methods, to prevent displacement and ensure proper contact with the wound bed.
Post-Application Care After the graft is secured, appropriate dressings are applied, and the area is monitored for signs of infection or graft rejection. Follow-up care is essential to assess the healing process and determine if further interventions are necessary.

3. Post-Procedure

Post-procedure care following the application of a dermal xenograft is critical for ensuring optimal healing and minimizing complications. Patients are typically monitored for signs of infection, graft rejection, or other adverse reactions. It is essential to keep the graft site clean and dry, and patients may be advised to avoid activities that could disrupt the graft. Follow-up appointments are necessary to evaluate the healing progress and to determine if additional treatments or interventions are required. The duration of recovery may vary depending on the size and location of the graft, as well as the patient's overall health and response to the procedure.

Short Descr	APPLY SKN XGRFT F/N/HF/G ADD
Medium Descr	XENOGRAFT TEMP CLOSURE F/S/N/H/F/G/M/D EA 100CM
Long Descr	XENOGRAFT TEMP CLOSURE F/S/N/H/F/G/M/D EA 100CM
Status Code	Active Code
Global Days	ZZZ - Code Related to Another Service
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	Discontinued Code
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	172 - Skin graft