2025 CPT code 15005
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Surgical preparation of an additional 100 sq cm or 1% body area (infants & children under 10) of recipient site for skin grafting; add-on code.
Modifiers may be applicable depending on the circumstances of the additional preparation (e.g., modifier 59 for a distinct additional procedure).Consult the CPT manual and payer guidelines for specific modifier usage.
Medical necessity is established by the need for skin grafting due to significant burn injuries, large lacerations, or extensive scar contractures.The additional preparation covered by code 15005 is deemed medically necessary when the initial preparation is insufficient to cover the required grafting area.
The clinical responsibility involves preparing the recipient site for skin grafting by excising or releasing scar tissue and ensuring proper hemostasis. This includes marking the area, incising the skin and subcutaneous tissue, and creating a healthy tissue bed suitable for grafting.
In simple words: This code is for extra work preparing the skin for a skin graft.If a doctor is already preparing a large area for a skin graft and needs to prepare a bigger area at the same visit, they use this code in addition to the code for the main skin graft preparation. This is for adults or children who need extra skin prepared beyond the first 100 square centimeters, or for small children who need more than one percent of their body surface prepared.
This CPT code, 15005, represents the surgical preparation of a recipient site for skin grafting.It's an add-on code used when, at the same encounter, the provider extends the preparation of a site beyond the initial 100 sq cm (or 1% body surface area for children under 10). This extension involves excising open wounds, burn eschar, or scar tissue, including subcutaneous tissues, or performing an incisional release of scar contracture. The procedure is performed on areas such as the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, or multiple digits.The code is specifically for the *additional* preparation beyond the initial 100 sq cm or 1% of body surface area.It must be reported in addition to the primary procedure code (e.g., 15004) for the initial preparation.
Example 1: A patient presents with a significant burn on their face, requiring skin grafting. The initial 100 sq cm is prepared using code 15004, and an additional 50 sq cm requires preparation, necessitating the use of code 15005., A child sustains a large laceration across their leg, requiring skin grafting.The initial 1% body surface area is prepared (code 15004), and an additional 0.5% area requires preparation (code 15005)., A patient undergoes a mastectomy, leaving a large area requiring skin grafting. Code 15004 is used for the initial preparation, and code 15005 is added for the subsequent preparation of an additional area exceeding 100 sq cm.
Detailed documentation is required, including the size of the initial prepared area, the size of the additional area prepared using code 15005 (in sq cm or % of body surface area for children under 10), the location of the prepared sites, the type of wound, the extent of tissue excision or release, and photographic evidence where appropriate.
** Payers may have specific requirements regarding documentation and medical necessity for this add-on code.Always refer to payer-specific guidelines for accurate billing and reimbursement.
- Revenue Code: P1G (Major Procedure - Other)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Plastic Surgery, Burn Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center