From year 2020, new cpt codes have been for coding grafting procedures. The old CPT code 20926 will be replaced by 5 new CPT codes for coding grafting .   From 2020, CPT code 20926 is deleted, and you have to search for the replacement codes to the integumentary system section. 

The new cpt codes are based on the site or location for grafting procedures. For grafting procedures of trunk, breasts scalp, arms, legs we have to use CPT code 15771 & +15772 while for Face, Eyelids, Mouth, Neck, Ears, Orbits, Genitalia, Hands, Feet we have use CPT code 15773 & +15774.

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Description of CPT code 15771, +15772, 15773,+15774 & 15769

Fat: Trunk, Breasts, Scalp, Arms, Legs

• 15771 (Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate)
• +15772 (… each additional 50 cc injectate, or part thereof (list separately in addition to code for primary procedure))

Fat: Face, Eyelids, Mouth, Neck, Ears, Orbits, Genitalia, Hands, Feet

• 15769 (Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia))
• 15773 (Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate)
• +15774 (… each additional 25 cc injectate, or part thereof (list separately in addition to code for primary procedure))

When you read the descriptors, remember that the body parts listed, such as “trunk, breasts, scalp, arms, and/or legs” in 15771, are the recipient sites. You don’t choose the code based on the donor site.

Each code from 15771 to +15774 includes a number reflecting the volume of the total amount of injectate. The word “total” is important here. “For multiple sites of injection, sum the total volume of injectate to anatomic sites that are grouped together into the same code descriptor,” the CPT^® guidelines state. Based on this instruction, you will report 50 cc of injectate injected into the face and mouth using both 15773 (25 cc or less) and +15774 (each additional 25 cc or part thereof).

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Medical coders should report primary codes 15771 and 15773 only once per session. Code 15771 is the primary code for +15772, and 15773 is the primary code for +15774.

CPT code 15769 represents autologous soft tissue grafts harvested by direct excision. Autologous means the grafts are obtained from the same individual who then receives the grafts. Fat, dermis, and fascia are examples (but not an exhaustive list) of the types of soft tissue grafts involved

To help prevent overuse of this new code, the guidelines remind you that you should use a more specific code if available, such as the appropriate codes for autologous grafts of skin, bone, nerve, tendon, fascia lata, or vessels.

References:

https://blog.supercoder.com/coding-updates/translate-cpt-2020-tissue-grafting-code-descriptors-for-accurate-claims/

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