CPT® Code 15366

Code deleted, see 15275-15278

Official Description

Tissue cultured allogeneic dermal substitute, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Common Language Description

A tissue cultured allogeneic dermal substitute is a specialized medical product used to treat wounds or skin defects on various parts of the body, including the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and multiple digits. This substitute is derived from human fibroblast cells, which are essential components of the skin that help in wound healing and tissue regeneration. The fibroblasts are cultivated from newborn foreskin tissue and are then seeded onto a bioabsorbable mesh scaffold. As these fibroblasts proliferate, they fill the mesh scaffold and produce important substances such as human dermal collagen, matrix proteins, growth factors, and cytokines. These components play a crucial role in regulating the immune response and promoting healing. The resulting dermal substitute is metabolically active and contains living cells, making it a dynamic option for wound coverage. During the procedure, the dermal substitute is carefully removed from its transport container and applied to a prepared wound bed, where it is secured using sutures or staples. Following this, a layered dressing is applied to protect the substitute and facilitate healing, which includes a nonadherent layer, a bulky layer of gauze, a compression layer, and an anti-shear layer. For billing purposes, CPT® Code 15365 is used for the first 100 square centimeters or less in adults or for 1% of total body surface area (TBSA) in infants and children, while CPT® Code 15366 is designated for each additional 100 square centimeters in adults or each additional 1% of TBSA in infants and children, or part thereof.

1. Indications

The tissue cultured allogeneic dermal substitute is indicated for use in patients requiring coverage for wounds or skin defects located on specific areas of the body. These areas include:

Face Wounds or defects on the facial region.
Scalp Injuries or skin issues affecting the scalp.
Eyelids Coverage for wounds on the eyelids.
Mouth Defects or wounds in the oral region.
Neck Skin defects located on the neck.
Ears Wounds affecting the ear area.
Orbits Injuries around the eye sockets.
Genitalia Coverage for wounds in the genital area.
Hands Skin defects on the hands.
Feet Wounds affecting the feet.
Multiple Digits Coverage for skin defects on multiple fingers or toes.

2. Procedure

The procedure for applying a tissue cultured allogeneic dermal substitute involves several critical steps to ensure proper placement and effectiveness. First, the wound bed must be adequately prepared, which may include cleaning the area and removing any necrotic tissue to promote optimal healing conditions. Once the wound bed is prepared, the tissue cultured allogeneic dermal substitute is carefully removed from its transport container. The substitute, which contains living fibroblast cells, is then positioned over the wound site. It is essential to secure the substitute in place using sutures or staples to prevent displacement and ensure proper adherence to the wound bed. After securing the dermal substitute, a layered dressing is applied to protect the area and facilitate healing. This dressing typically consists of a nonadherent layer to prevent sticking to the substitute, followed by a bulky layer of gauze to absorb any exudate. A compression layer may be added to provide support and reduce swelling, and finally, an anti-shear layer is included to minimize friction and movement that could disrupt the healing process. This comprehensive approach helps to create an optimal environment for healing while ensuring the dermal substitute remains in place.

3. Post-Procedure

Post-procedure care for patients receiving a tissue cultured allogeneic dermal substitute is crucial for successful healing. Patients should be monitored for any signs of infection or complications at the site of application. It is important to keep the dressing intact and dry, as moisture can compromise the integrity of the substitute and the healing process. Follow-up appointments may be necessary to assess the healing progress and to change the dressing as needed. Patients should be advised on signs of potential complications, such as increased redness, swelling, or discharge from the wound site, and instructed to contact their healthcare provider if these occur. The expected recovery time may vary depending on the size and location of the wound, as well as the individual patient's healing response. Overall, proper post-procedure care is essential to ensure the effectiveness of the tissue cultured allogeneic dermal substitute and to promote optimal healing outcomes.

Short Descr	APPLY CULT DERM F/HF/G ADD
Medium Descr	TISS CLTR ALGC DRM F/S/N/H/F/G/M/D EA 100 CM
Long Descr	TISS CLTR ALGC DRM F/S/N/H/F/G/M/D EA 100 CM
Status Code	Active Code
Global Days	ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Discontinued Code
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	172 - Skin graft