A graft is a section of skin, of variable thickness and size, completely detached from its original site and moved to cover the zone to be repaired. Split thickness and full thickness, these are all indicating theyre coming from the patient themselves versus a cadaver. Splitthickness skin grafting stsg is surgery to cover and repair areas of skin loss or defect. Skin grafting is a surgical procedure by which skin or skin substitute is placed over a burn.
The doctor did a splitthickness autograft of the leg. A splitthickness skin graft stsg contains epidermis and a variable amount of dermis. An ulceration of the distal right leg was also noted and repaired with split thickness skin graft. Lets compare this new technique to the other ways the epidermis, the outermost layer of skin, can be grafted from the. The remaining half of the skin in the donor area will generate a new surface half over the next few weeks. Stsg uses the epidermis and some parts of the dermis skin layers taken from one area of the body and transplanted to another area. Generally, we reduce wound depth and exposed structures via npwt, which encourages margins to adhere. Split thickness skin graft is a graft where only part of the skin. Skin grafts medical coding when to use one or two codes. This 2020 icd 10 pcs code is to be used for discharges occurring from october 1, 2019 through september 30, 2020. To report our successful outcomes of genital splitthickness skin graft stsg in covering major skin loss and providing good functional and cosmetic outcomes. Procedure code description medicaid fee 20 medquest. Utilities of splitthickness skin grafting for male. Code the diagnoses using icd10cm and procedures using icd10pcs.
Epidermal grafting eg is an alternative method of autologous skin grafting that harvests only the epidermal layer of the skin by applying. In general, if there is too little donor skin available stsg is applied as meshed and expanded, in order to. You report these using 15350 application of allograft, skin. We reduce wound surface area through either secondary intention and biologics or skin grafting. Splitthickness a splitthickness skin graft stsg is a skin graft including the epidermis and part of the dermis. One type of autograft is a splitthickness skin graft.
Case example split thickness skin graft stsg zimmer dermatome. The latissimus dorsi muscle was raised, placed into the defect and arterial and venous anastomoses were. Definition of splitskin graft in the legal dictionary by free online english dictionary and encyclopedia. Cpt 15100 is correct in this case because it tells first 100 sq cm or less. Splitthickness skin graft is used to cover a large skin injury which may not have enough blood vessels left intact.
During a splitthickness skin graft, your surgeon will remove a thin layer of skin from 1 part of your body donor site and use it to close the surgical site that needs to be covered recipient site. The graft can be meshed to expand the graft if needed. John has chronic ulcers of the right calf and back. Splitthickness skin graft definition of splitthickness. Is it ok if you dont need two codes, how do i know when to use one or. Splitthickness skin graft stsgfor more images and videos of techinque of harvest, care of donor site. A split thickness skin graft is a procedure in which a surgeon removes the outer layer of skin from a part of your body and uses it to cover an open wound in another part of your body.
The dermatologist uses nonhuman animal tissue, called a xenograft. Icd10pcs is a procedure classification published by the united states for classifying procedures performed in hospital inpatient health care settings. Diseases of the skin and subcutaneous tissue l00l99. A full thickness skin graft is more risky, in terms of the body accepting the skin, yet it leaves only a scar line on the donor section, similar to a cesareansection scar. The ssg contains a portion of the top layer of skin the epidermis and some of the layers under this dermal layers. Aug 12, 2019 by lynn kuehn, ms, rhia, ccsp, fahima icd10pcs fy2020 brings us another different way to complete the process of epidermal autografting a new method called cell suspension technique. According to their thickness, skin grafts are classified as split thickness or partial and full thickness. There are two standalone codes for split thickness skin grafts. Mar 03, 2018 a closer look at the disadvantages of split thickness skin grafts. Splitthickness graft definition of splitthickness graft. Revision procedure coding system icd10pcs is a new sys tem for coding. A fullthickness skin graft ftsg includes all of the dermis as well as the epidermis 8 fig 1.
Icd10cm official guidelines for coding and reporting. In the case of full thickness skin grafts, the donor section will often heal much more quickly than the injury and causes less pain than a partial thickness skin graft. This procedure is done when you have an open wound and all of the skin has been lost. Ollier in 1872 pointed out the importance of the dermis in skin grafts, and in 1886 thiersch used thin split thickness skin to cover large wounds. Skin grafts medical coding if you have a patient that is getting an autologous split thickness graft, taken from the thigh and attached to the tip of the nose, is it alright to use one code like 15120 for the harvesting and attachment. May 17, 2016 split thickness skin grafting ssg is an important modality for wound closure. Code the diagnoses using icd 10 cm and procedures using icd 10 pcs. Each icd 10 pcs code has a structure of seven alphanumeric characters and contains no decimals. Similar to icd9cm, icd10pcs differentiates a total replacement versus replacement of only some of the knee components. Replacement of left lower leg skin with synthetic substitute, full thickness. So, just like there were blood banks, theres also skin banks, tendon banks. The patient, a 62yearold male, was diagnosed with skin cancer that had eroded into his frontal bone as well as brain.
R, operation, replacement, total hip replacement, bone graft, free skin graft. How to perform a split thickness skin graft off the calf, leg to close an open wound duration. Split thickness skin grafts stsg are thin, including epidermis and a small portion of dermis. As size of graft was 5 cm x 16 cm means 80 cm, you could use only 15100, no need additionally 15101. Because a split thickness skin graft was needed to cover the flap, skin graft was harvested from the thigh.
Primary contraction, an elastic recoil of the skin caused by retractile forces, occurs as soon as the graft is harvested. Primary care physicians often see wounds in which skin loss is a major factor. Dec 17, 2015 the doctor did a splitthickness autograft of the leg. This logo represents the university of iowa health care. A 56yearold woman presented to the ambulatory surgery center with a 3. In general, if there is too little donor skin available stsg is applied as meshed and expanded, in order to maximize graft coverage, or intact sheets. The former is further divided into thin, intermediate and thick. Fullthickness skin graft to right lower arm, autograft do not code graft harvest. It was excised, found to be melanoma, and a full thickness skin graft is excised from her thigh and placed on the 10 sq cm defect. Splitthickness grafts can survive in less ideal recipient sites with less vascularity, but the thinner the graft. Feb 03, 2020 split thickness skin grafting stsg is surgery to cover and repair areas of skin loss or defect. A split skin graft ssg is where a very thin shaving of normal, healthy skin is used to cover an area of skin that has been damaged or cannot heal because of an injury e. Skin grafts, splitthickness and fullthickness woundsource. It is commonly used to repair large but not too deep skin ulcers, diabetic or traumatic wounds, and burns.
Educate surgeons about the importance of clearly documenting the anatomical location used to harvest a graft. This takes the two top layers of skin from the donor site the epidermis and the layer under the epidermis the dermis. Both graft and donor sites will need a longer time to heal than normal wounds, and are often painful. Splitskin graft legal definition of splitskin graft. Mar 14, 2014 how to perform a split thickness skin graft off the calf, leg to close an open wound duration. Primary contraction, an elastic recoil of the skin caused by retractile forces, occurs as. Occasionally revisions will be necessary for optimal outcome. Federal governments department of health and human. A splitthickness skin graft includes the epidermis and varying amounts of dermis, ranging between 8 of an inch 0. It is often placed in areas with deep or widespread skin burn. Mar 03, 20 generally, we reduce wound depth and exposed structures via npwt, which encourages margins to adhere. Mar 16, 2016 icd 10 pcs represents a major departure from icd 9cm procedure coding, and as such, many coding specialists find icd 10 pcs much more challenging to learn than icd 10 cm which still shares many similarities with icd 9cm. Splitthickness skin grafting inpatient care what you. Is it ok if you dont need two codes, how do i know when to use one or two codes for a procedure.
Fetal or inutero surgery is coded to the products of conception body part. Oct 09, 2018 icd 10 pcs represents a major departure from icd 9cm procedure coding, and as such, many coding specialists find icd 10 pcs much more challenging to learn than icd 10 cm which still shares many similarities with icd 9cm. In order to ease the transition from one code set to the other, we are prov. About your splitthickness skin graft memorial sloan. To report our successful outcomes of genital split thickness skin graft stsg in covering major skin loss and providing good functional and cosmetic outcomes. Utilities of splitthickness skin grafting for male genital. Home health care icd10cm coding tip sheet overview of key chapter updates for home health care and top 20 codes chapter 4. Most people who are having a skin graft have a splitthickness skin graft. Icd10pcs official guidelines for coding and reporting. Your wound has been repaired by covering it with a split thickness skin graft. This information describes surgery using a splitthickness skin graft. The code is valid for the year 2019 for the submission of hipaacovered transactions.
It was excised, found to be melanoma, and a fullthickness skin graft is excised from her thigh and placed on the 10 sq cm defect. Case example split thickness skin graft stsg zimmer. Split thickness skin graft iowa head and neck protocols. Its thickness depends on the donor site and the needs of the person receiving the graft.
Splitthickness skin grafts involve only the epidermis and a small portion of the dermis, leaving behind enough of the dermis for the donor site to heal by reepithelialization. Having a split thickness skin graft may put you at risk of other problems. In icd10pcs the components of the knee, as well as laterality, being replaced are captured by the fourth character, body part, of the code. They do have allografts and homografts that come from cadaver. Guidelines for coding and report in the aapc 2020 icd10cm coding books for additional guidelines. These are areas of the body that are subject to abrasion or are a weightbearing parts your body.
Autologous splitthickness skin graft stsg is the gold standard for the reconstruction of diabetic foot ulcerations. The donor site skin grafts and skin substitutes james f thornton md. Split thickness skin graft general surgery coding ask. What are the risks of having a split thickness skin graft. This information describes surgery using a split thickness skin graft. Coding for mastectomy use the correct icd10 and cpt codes. If the wound is on the face, neck, or hand, the stsg is applied as a sheet graft.
A 10step guide to applying split thickness skin grafts. However, there are multiple limitations and disadvantages associated with stsgs. This is the ninth in a series of 10 articles discussing the 31 root operations of icd10pcs. Icd10pcs represents a major departure from icd9cm procedure coding, and. It can be processed through a skin mesher which makes apertures onto the graft, allowing it to expand up to nine times its size. The top half of the skin has been removed from a donor area and then sutured onto your wound. The amount of dermis taken for the graft will be determined by the surgeon. Splitthickness grafts are commonly not performed on your hands and feet. During a split thickness skin graft, your surgeon will remove a thin layer of skin from 1 part of your body donor site and use it to close the surgical site that needs to be covered recipient site. The code is valid for the year 2020 for the submission of hipaacovered transactions. Both ulcers are excisionally debrided, and the ulcer of the back has a split thickness skin graft, autologous. A number 15 blade is then used to cut the skin from the dermatome and the graft is transferred to the recipient site. Icd10pcs 0hrmxk3 is a billable procedure code used to specify the performance of replacement of right foot skin with nonautologous tissue substitute, full thickness, external approach.
Splitthickness skin grafting the splitthickness skin graft stsg is the most frequently used donor for tissue coverage. Autologous split thickness skin graft stsg is the gold standard for the reconstruction of diabetic foot ulcerations. Federal governments department of health and human services dhhs provide the following guidelines for. Icd10pcs official guidelines for coding and reporting 2017 the centers for medicare and medicaid services cms and the national center for health statistics nchs, two departments within the u. Split thickness skin graft stsg for more images and videos of techinque of harvest, care of donor site. Home health care icd 10 cm coding tip sheet overview of key chapter updates for home health care and top 20 codes chapter 4. In 1869 reverdin rekinkled worldwide interest in skin graft ing with his report of successful pinch grafts. However, the donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring. Icd10pcs represents a major departure from icd9cm procedure coding, and as such, many coding specialists find icd10pcs much more challenging to learn than icd10cm which still shares many similarities with icd9cm.
Healthy skin is taken from a place on your body called the donor site. Fetal or in utero surgery is coded to the products of conception body part. Aug 31, 2018 coding for mastectomy use the correct icd10 and cpt codes. A splitthickness skin graft is a procedure in which a surgeon removes the outer layer of skin from a part of your body and uses it to cover an open wound in another part of your body. Endocrine, nutritional and metabolic diseases e00e99 icd10cm diabetes mellitus codes are now combination codes that include the type of. Lets compare this new technique to the other ways the epidermis, the outermost layer of skin, can be grafted from the patients own skin. Icd9cm volume 3 is a system of procedural codes used by health insurers to classify medical. A closer look at the disadvantages of splitthickness skin grafts.
Icd 10 pcs is a procedure classification published by the united states for classifying procedures performed in hospital inpatient health care settings. If the device is removed prior to the completion of the procedure then we do not. Splitthickness skin grafting ssg is an important modality for wound closure. Wound care instructions for split thickness skin grafts your wound has been repaired by covering it with a split thickness skin graft. Although most of these wounds will heal with local care and with a reasonable functional result, split thickness skin grafting as a simple outpatient or bedside procedure can speed healing more comfortably for the patient and with greatly improved functional results. Graft contraction, graft failure, hyperpigmentation, itchiness and dryness of the graft, durability and growth problems are the most common complications of split thickness skin grafting. Failed lattisimus dorsi free flap aha coding clinic for. Forceps then are used to hold the split thickness graft and the dermatome is advanced further to acquire the graft. Split thickness grafts are commonly not performed on your hands and feet. Replace r low arm skin w autol sub, full thick, extern 0hrdx73 is a billable medical code. I cant find the cpt code for this procedure for an adult.