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Coding Xenograft application

Darlene

Member
Blitzer
Indications:15-year-old boy was burned in a fire and assessed to have received burns to 75 percent of his total body surface area. He was transferred to a burn center for definitive treatment. Once stable, he was brought to the OR.


Procedure: Due to extent of the patient’s burns and lack of sufficient donor sites, his full-thickness burns will be excised and covered with xenograft, and a split-thickness skin biopsy will be harvested for preparation of autologous grafts to be applied in the coming weeks, when available. After induction of anesthesia, extensive debridement of the full-thickness burns was undertaken. Attention was first directed to the patient’s face, neck, and scalp. A total of 500 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved using electrocautery. Attention was then turned to the trunk. A total of 950 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved. Attention was then turned to the arms and legs. A total of 725 sq cm received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved. Attention was then turned to the hands and feet. A total of 300 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. All involved areas were then covered with xenograft. Finally a split thickness skin graft of 0.015 inches in depth was harvested using a dermatome from a separate donor site. A total of 85 sq cm was recovered. What procedures codes would be reported service?
A. 15200, 15201 x 123, 15004, 15005, 15002, 15003
B. 15275, 15276 x 31, 15271, 15272 x 66, 15004, 15005 x 16, 15002, 15003 x 7
C. 15277, 15278 x 7, 15273, 15274 x 16, 15004, 15005 x 7, 15002, 15003 x 16, 15040
D. 15130, 15131 x 7, 15135, 15136 x 16, 15004, 15005 x 7, 15002, 15003 x 16

The answer is C, but can you please tell me why they coded the lesser areas first instead of the trunk and extremities. Is it because they did that procedure first or because the head is a much more critical area of the body?
 

Laureen

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Here's my worksheet for figuring out the answer. Watch this video to see how I worked it out.
A. 15200, 15201 x 123, 15004, 15005, 15002, 15003
B. 15275, 15276 x 31, 15271, 15272 x 66, 15004, 15005 x 16, 15002, 15003 x 7
C. 15277, 15278 x 7, 15273, 15274 x 16, 15004, 15005 x 7, 15002, 15003 x 16, 15040
D. 15130, 15131 x 7, 15135, 15136 x 16, 15004, 15005 x 7, 15002, 15003 x 16

Trunk == 750
Arms, legs = 725

face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet
Face,neck,scalk = 500
hands, feet = 300
Total = 800
 
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