Summary & Overview
CPT 15152: Tissue Cultured Epidermal Autograft for Pediatric Wounds
CPT code 15152 reports the application of a tissue cultured epidermal autograft for open wounds or burns on the trunk, arms, or legs in infants and children, billed for each additional 100 cm2 or 1 percent body area after the initial 100 cm2. Nationally, this code is relevant for burn centers, pediatric surgical services, and facilities that manage complex wound coverage where skin grafting with cultured epidermal autografts is required. Payers commonly engaged with this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find clinical context about the procedure and expected settings of care, plus operational guidance on the unit-based nature of the code (per additional 100 cm2 or percent body area). The publication provides benchmarks and comparative information for major payers listed above, highlights common billing modifiers used with complex graft procedures, and summarizes policy considerations that affect coverage and reimbursement for pediatric autograft services. The content aims to inform billing staff, clinical program leaders, and policy analysts about coding application, payer scope, and the clinical scenarios that typically require use of CPT code 15152. Data not available in the input for specific payer rates, ICD-10 pairings, and associated taxonomies is noted where applicable.
Billing Code Overview
CPT code 15152 describes coverage of an open wound or burn on the trunk, arms, or legs using a tissue cultured epidermal autograft. This code applies when the provider treats each additional 100 cm2 or 1 percent of body area in an infant or child after the first 100 cm2 has been accounted for.
Service Type: Surgical/dermatologic grafting procedure
Typical Site of Service: Hospital operating room, ambulatory surgery center, or specialized burn unit
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adult patient with a deep partial-thickness or full-thickness burn or an open traumatic wound on the trunk, arms, or legs requiring coverage beyond the first 100 cm2. The workflow begins with an acute assessment in the burn center or operating room: initial resuscitation and wound debridement, measurement of the total wound area, and decision by the burn surgeon or reconstructive plastic surgeon to use a tissue-cultured epidermal autograft. The autograft is prepared in a laboratory from the patient’s keratinocyte culture, and the operating team applies the cultured epidermal sheets to the wound bed during a surgical procedure under general anesthesia. Postoperative care includes dressing changes, infection surveillance, outpatient wound clinic follow-up, and rehabilitation to monitor graft take and functional recovery. Typical sites of service include inpatient hospital operating rooms for acute procedures and specialized burn centers; outpatient specialized procedure suites may be used for staged or follow-up grafting in select cases.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Principal physician service | Use when the surgeon performs the primary procedure and is the primary clinician directing care during operative encounter. |
22 |