Coding failed skin grafts for burns

trasmussen1

Scenario:  
The patient was admitted, March 14, 2018, for his burn,
underwent debridement, then allograft, then Integra. The patient was
discharged back to home. Comes into the clinic today for further evaluation.
Was noted to have had some issues with silicone separation and purulence on clinic visit on April 9, 2018. He has been doing dressing changes. Soap and water washes. Now admitted for more debridement and allograft and integra.  Which should be sequenced first.  The original burn or other complications of a skin graft (allograft)?

Thanks,

Tracie Rasmussen

mgayle4@gmail.com

Tracie, I code this as a subsequent encounter for the burn.

Martin

evanspx@sutterhealth.org

But, you also describe complications of previously placed skin graft...separation, infection, and failed graft are coded as complications.  

T85.693?

T86.820

T86.821

evanspx@sutterhealth.org

VOLUME 29      THIRD QUARTER

NUMBER 3       2012, Page 6

 

Failure of Apligraf Application

 

Question: A patient who is status post Apligraf application is admitted for treatment after failure of the graft. Which is the correct complication code, 996.55, Complication due to artificial skin graft or 996.52, Complication due to graft of other tissue, NEC? Since Apligraf® is a “living cell” based product, it seems to fit the category of “other tissue” rather than “artificial skin.”

 

Answer: Assign code 996.52, Mechanical complication of other specified prosthetic device, implant, and graft, due to graft of other tissue, NEC, for the failure of the Apligraf®. Apligraf® is a biological substance that is created from living cells found in healthy human skin. It is used to treat nonhealing wounds (e.g., diabetic foot ulcers and venous ulcers), which do not respond to conventional therapies. Other examples of biological wound care products that include graft of other human tissue are Celtx and Dermagraft.

morris-jeff@CooperHealth.edu

Complication of graft should be sequenced first.