RHIA practice question 22 of 35
Nonhuman graft for temporary wound closure. Patient has a 5 cm defect on the scalp.
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The procedure involves a "nonhuman graft," which is a xenograft, used for "temporary wound closure" on the "scalp." CPT code 15420 specifically describes the application of a xenograft for temporary wound closure on anatomically specific areas, including the scalp. The defect size of 5 cm falls within the "first 100 sq cm or less" parameter of this base code. According to CPT coding guidelines, the most specific code that accurately describes the procedure and location must be selected. Therefore, 15420 is the correct code.
A. 15335: This code is for acellular dermal replacement, a different type of graft material and procedure, not a xenograft for temporary closure.
B. 15400: This code is for a xenograft on the trunk, arms, or legs. It is incorrect because a more specific code (15420) exists for the scalp.
D. 15430: This code describes an acellular xenograft implant, typically used for soft tissue reinforcement, which is a different procedure than a temporary skin closure graft.
1. American Medical Association (AMA). (2023). CPT® 2024 Professional Edition.
Section: Skin Replacement Surgery and Skin Substitutes
Codes 15400-15421.
Page/Descriptor for 15420: "Xenograft
skin (dermal)
for temporary wound closure
face
scalp
eyelids
mouth
neck
ears
orbits
genitalia
hands
feet
and/or multiple digits; first 100 sq cm or less
or 1% of body area of infants and children."
Page/Descriptor for 15400: "Xenograft
skin (dermal)
for temporary wound closure
trunk
arms
legs; first 100 sq cm or less..." The notes clarify that 15400 should not be used when a more specific anatomical code like 15420 applies.
2. Johns
M. L. (2021). Health Information Management Technology: An Applied Approach (6th ed.). AHIMA Press.
Chapter 15: Procedural Coding
Section: Integumentary System. This chapter explains the CPT coding principle of selecting the most specific code available. It details how graft codes are chosen based on the type of graft (e.g.
xenograft)
the purpose (e.g.
temporary closure)
and the specific anatomical site
which directly supports the selection of 15420 over the more general 15400 for a scalp procedure.
3. University of Alabama at Birmingham. (n.d.). HIM 350: Principles of Medical Coding I Course Syllabus.
Module: CPT Integumentary System. Course materials emphasize the importance of anatomical specificity in CPT coding for skin grafts. The hierarchy of codes
where specific sites (face
scalp) are coded differently from general sites (trunk
arms)
is a key learning objective
reinforcing that 15420 is the correct choice for the scalp.
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