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 | Increased procedural services | Use when documentation supports substantially greater work than typical for the procedure (complexity, prolonged time). |
23 | Unusual anesthesia | Use when procedure is performed under general anesthesia due to patient condition or pain that would otherwise preclude local/regional. |
26 | Professional component | Use if billing only the professional component separate from facility or technical component for services eligible for split billing. |
50 | Bilateral procedure | Use when identical tissue-cultured epidermal autografts are applied to symmetric bilateral areas and payer allows bilateral modifier for the service. |
52 | Reduced services | Use if a reduced or partial procedure is performed relative to the full descriptor. |
53 | Discontinued procedure | Use if the procedure was started but discontinued for reasons unrelated to patient's condition (document reason). |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure. |
63 | Procedure performed on infants and children | Use for age-related reporting when payer requires a specific modifier for pediatric procedures. |
78 | Unplanned return to OR by same physician following initial procedure for a related procedure during the postoperative period | Use when a patient requires an unplanned return to the operating room for graft revision or management of a complication. |
80 | Assistant surgeon | Use when an assistant surgeon is documented and the payer permits payment for assistant services. |
81 | Minimum assistant surgeon | Use when a minimal assistant role is documented and allowed by payer policies. |
82 | Assistant surgeon (when qualified resident not available) | Use when a qualified resident is not available and an assistant is required. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services billed under their NPI | Use when a mid-level provider performs a billable portion of the procedure or postoperative management per payer rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208200000X | General Surgery | Burn and wound surgeons who perform surgical grafting and debridement. |
| 207L00000X | Plastic Surgery | Reconstructive plastic surgeons who perform cultured epidermal autografts and complex wound coverage. |
| 207P00000X | Pediatric Surgery | Pediatric surgeons involved for infants and children with extensive burns. |
| 2086S0102X | Burn Surgery (specialty within general/plastic) | Practitioners specializing in burn care in dedicated burn centers. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
T31.0 | Burns involving less than 10% of body surface | Common burn extent that may require cultured epidermal grafting when depth warrants. |
T31.1 | Burns involving 10–19% of body surface | Larger TBSA burns for which serial cultured epidermal applications may be required. |
T30.0 | Burn of face, head and neck, unspecified degree | Anatomical descriptor; grafting decisions depend on depth and location. |
T23.3 | Burn of second degree of shoulder and upper arm | Site-specific code relevant when grafts are placed on the arm. |
T24.3 | Burn of second degree of hip and thigh | Site-specific code relevant when grafts are placed on the trunk/leg regions. |
S01.81XA | Laceration without foreign body of other part of trunk, initial encounter | Traumatic full-thickness wounds that may require cultured epidermal coverage. |
L98.4 | Non-pressure chronic ulcer of skin, unspecified | Chronic nonhealing wounds that in select cases may be treated with advanced biologic grafting. |
T25.0 | Burn of first degree of foot | Superficial burns generally not treated with cultured epidermal autograft but included for anatomical context. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
15150 | Tissue cultured epidermal autograft, first 100 sq cm or 1 percent body area of infant or child | Primary code for the initial 100 cm2; 15152 is used for each additional 100 cm2 or 1 percent of body area. |
11042 | Debridement, subcutaneous tissue (includes epidermis and dermis), first 20 sq cm or less | Commonly performed immediately prior to graft placement to prepare the wound bed. |
15777 | Placement of a biologic implant (e.g., dermal regeneration template) | May be used in staged reconstruction when dermal substitutes are placed before epidermal grafting. |
13160 | Secondary closure of surgical wound, with tissue rearrangement (e.g., scar revision) | May be used later for revision of grafted areas or contouring after initial healing. |
29580 | Application of multilayer compression systems (for extremity grafts) | Used in postoperative care to support graft adherence and limb edema management. |