Coding, Classification and Reimbursement

CPT code for Nushield -not used as skin substitute

  • 1.  CPT code for Nushield -not used as skin substitute

    Posted 12-28-2018 16:37

    How is a Nushield skin substitute coded in this scenario?

    The allograft stem cell patch was placed around the FCR tendon so as to minimize adhesion. The subcutaneous tissue was closed using 3-0 nylon, the skin was closed using Dermabond and Prineo.

    Thank you.

    Ambulatory Surgery Coder

  • 2.  RE: CPT code for Nushield -not used as skin substitute

    Posted 01-02-2019 10:18
    ​I would consider CPT 17999 based on CPT Assistant October 2013 page 15, which includes the following advice:

    There is a parenthetical note for deleted codes 15430 and 15431 which instructs users to report the new Skin Substitute Graft codes 15271-15278 instead. However, these Skin Substitute Graft codes are reported for the topical application of skin substitute grafts involving only the Integumentary System. Code 15777, Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (List separately in addition to code for primary procedure), was created to report the placement of non-surface biological implants for soft tissue reinforcement for only the Integumentary System.

    If implants for soft tissue reinforcement are used in other anatomical areas, and the implant reinforcement is not inherent to the procedure performed, then it may be separately reported with unlisted code 17999, Unlisted procedure, skin, mucous membrane and subcutaneous tissue. However, if the soft tissue reinforcement placed is an inherent part of the procedure performed, it is not appropriate to separately report unlisted code 17999.

    Crystal Crafts, RHIT CCS
    Coding Manager