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Official Description

Graft; derma-fat-fascia

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 15770 refers to a specific type of surgical graft known as a derma-fat-fascia graft. This composite graft is composed of three distinct layers: the epidermis, dermis, and fat, with fascia at the base. The graft is typically harvested from the ear, where the anatomical structure allows for the collection of these layers in a single piece. The process begins with the determination of the size and configuration of the graft, which is traced onto the donor site to ensure precision. Prior to excision, mattress sutures may be placed through the graft to stabilize the tissue layers, preventing them from separating during the harvesting process. Once the graft is excised, it is prepared for transfer to the recipient site, where it will be used to address soft tissue defects. The donor site is then closed primarily to promote healing. This type of grafting is often performed for reconstructive or aesthetic purposes, aiming to correct volume loss or contour deformities resulting from various conditions such as disease, trauma, tumor removal, or congenital defects. The procedure is integral in restoring the natural appearance and function of the affected area.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The derma-fat-fascia graft procedure, represented by CPT® Code 15770, is indicated for various conditions that result in soft tissue defects. These indications include:

  • Volume Loss - This procedure is performed to restore volume in areas where soft tissue has been lost due to trauma or surgical excision.
  • Contour Deformities - It is utilized to correct deformities in the contour of the skin that may arise from congenital defects or other medical conditions.
  • Reconstructive Needs - The graft is often necessary for reconstructive purposes following tumor extirpation or significant injury to the skin and underlying tissues.

2. Procedure

The procedure for harvesting and applying a derma-fat-fascia graft involves several critical steps, which are detailed as follows:

  • Step 1: Measurement and Marking - The first step involves measuring the defect that requires reconstruction. The surgeon carefully marks the donor site on the ear, ensuring that the size and configuration of the graft will adequately cover the defect.
  • Step 2: Graft Harvesting - Once the donor site is marked, the surgeon excises the graft, which consists of the epidermis, dermis, fat, and fascia. Mattress sutures may be placed through the graft to maintain the integrity of the tissue layers during this process.
  • Step 3: Preparation for Transfer - After harvesting, the graft is prepared for transfer to the recipient site. This preparation may involve shaping the graft to fit the specific contour of the defect.
  • Step 4: Recipient Site Incision - Incisions are made in the area where the graft will be placed. The surgeon ensures that the recipient site is ready to receive the graft.
  • Step 5: Graft Placement - The harvested derma-fat-fascia graft is then secured in place within the recipient site. This step is crucial for ensuring proper integration and healing.
  • Step 6: Closure of Incisions - Finally, the incisions at both the donor and recipient sites are closed primarily, promoting optimal healing and minimizing scarring.

3. Post-Procedure

After the derma-fat-fascia graft procedure, patients can expect a recovery period that may vary based on individual circumstances and the extent of the grafting. Post-procedure care typically includes monitoring the graft site for signs of infection, ensuring proper wound care, and following any specific instructions provided by the surgeon. Patients may be advised to avoid strenuous activities that could stress the graft site during the initial healing phase. Follow-up appointments are essential to assess the healing process and the integration of the graft into the surrounding tissue. The overall goal of post-procedure care is to ensure successful healing and optimal aesthetic outcomes.

Short Descr DERMA-FAT-FASCIA GRAFT
Medium Descr GRAFT DERMA-FAT-FASCIA
Long Descr Graft; derma-fat-fascia
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) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
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) P5A - Ambulatory procedures - skin
MUE 2
CCS Clinical Classification 172 - Skin graft
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).
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.
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.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
LT Left side (used to identify procedures performed on the left side of the body)
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.
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
RT Right side (used to identify procedures performed on the right side of the body)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
CR Catastrophe/disaster related
E2 Lower left, eyelid
E4 Lower right, eyelid
F4 Left hand, fifth digit
F9 Right hand, fifth digit
FA Left hand, thumb
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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