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Medical Coding Training — Understanding Tissue Grafts

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Okay so understanding tissue grafts. A student asked, "I'm having a hard time understanding the different types of grafts and how to code them. How do I know when to use more than one code?" Okay, one more slide before I go to document camera.

Okay so the first thing tha twe need to understand are the types of grafts out there. There are auo grafts which basically, auto meaning self so it's basically a graft coming from the patient. Then there's homologous grafts which are also known as homo or allo grafts, homo meaning same so it's coming from the same species. So another... a human donor, usually a cadaver because most people that are alive don't go around donating their skin. And then the 3rd type is the hetero or xeno graft and that can be like man-made or synthetic type of graft and those are becoming more and more popular and you'll see the code selection growing and growing because of all the different types. And then there's the animal grafts. Okay so hetero or xeno grafts and the codes in the CPT book are going to have those terms. It's important to understand that.

Alright, so if you have your CPT manuals, I'm going to start on page 71. And normally, when I start teaching grafts, I'm going to be talking tonight about the free grafts where they're you know, in the case of an auto graft, lifted from one part of the body and put on another part. It's not a twisting around of the skin and making a flap or something like that. Maybe I'll cover that on another webinar. But what I was going to talk about tonight is the free grafts.

So I normally ask, "Has anyone ever laid sod down in their yard?" And you don't have to... a group will say yes, I have. So do you normally just lay sod down or do you do something first? And you normally prepare the ground. You dig it up. You make sure that the soil's loose and ready to take that new sod because the goal is, when you lay the sod down, you want the roots of the grass in the sod to take into the new soil. Well, that's the way it is when you do a skin graft. You want the new skin, the graft to take on the recipient site. So it all starts with these surgical prep codes.

Now there's lots of guidelines that precede this but I'm going to dive right into where the codes are. There's two bubbles, 15002 which bubbles in... it's indented code 15003 and then 15004 which bubbles in the add on code 15005. The difference between the two is location, location, location. Alright so 002 is trunk, arms or legs and 004 is pretty much everything else. Bubbling and highlighting is a trademarked technique that we're known for as well and this is how you do it. It's actually quite simple. You just bubble in the parent code, the non-indented one with any indented codes and parenthetical notes and that becomes your bubble. And then you highlight everything after the semi-colon which every indented code is then highlighted.

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