January 2012

New CPT codes relate to Dermagraft

The American Medical Association (AMA) has assigned two new procedure codes for the application of living skin cell product Dermagraft, according to Westport, CT-based  manufacturer Advanced BioHealing. Dermagraft is approved by the Food and Drug Administration (FDA) for up to eight weekly applications over 12 weeks for treatment of diabetic foot ulcers.

The new CPT codes have a zero-day global period. These codes have no impact on the product’s FDA-approved indication, but will streamline the reimbursement process for providers and contractors, according to the AMA. The Dermagraft product code (HCPCS Q4106) is unchanged.

The new CPT codes are 15275: Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 cm2, first 25 cm2 or less wound surface area; and 15276: Each additional 25 cm2 wound surface area, or part thereof (list separately in addition to code for primary procedure).

These new codes, which affect application codes for all tissue-cultured allogeneic skin or dermal substitute products, were established in the AMA’s 2012 CPT book and included in the final Physician Fee Schedule ruling released by the Centers for Medicare and Medicaid Services in November.

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