Coding tips for CPT code 15771, 15772, 15773 & 15774

Description of CPT code 15771, 15772, 15773 and 15774

Autologous fat grafting may be utilized in many areas of soft tissue augmentation or reconstruction, including congenital defects, contouring of face or breasts, and scarring as a result of burns, radiation, surgical procedures, or trauma. The physician obtains an autologous fat graft by liposuction technique. After identifying the most suitable area of fat harvesting (commonly the abdomen, trochanteric region, or the insides of the thighs and/or knees), the physician makes small incisions in the skin overlying the harvest area. A liposuction cannula is inserted through the incision. The physician moves the cannula through the fat deposits, collecting parcels of fat.

The fat graft is processed using a variety of techniques, most commonly sedimentation, filtering, washing, and centrifugation. The physician inserts the fat graft at the chosen anatomical region. A small incision is made, a cannula is inserted, and the fat graft is typically distributed in small portions at varying depths into the soft tissues. Donor and recipient incisions are closed.

CPT code 15771 is reported once per session for grafting of 50 cc or less of the fat injectate to the trunk, breasts, scalp, arms, and/or legs, and 15772 for each additional 50 cc. CPT code 15773 is reported  once per session for grafting of 25 cc or less of the fat injectate to the face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet, and 15774 for each additional 25 cc.

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

Question: Would it be appropriate to report code 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, for harvesting 25 cc of autologous fat via liposuction, micronizing the adipose, inserting it into a Food and Drug Administration (FDA)-cleared three-dimensional (3D) printer to create an exact model of a skin deficit of a diabetic foot ulcer, and then surgically applying and securing the 3D graft into the wound (ie, not injecting via cannula)? If not, which code(s) would be appropriate to report the liposuction harvesting and 3D graft application procedures?

Answer: No, the procedure described should not be reported with code 15773. Codes 15771-15774 may be reported for autologous fat grafting depending on the volume of injectate when the adipose cells are harvested via a liposuction technique and prepared with minimal manipulation and then injected via cannula in multiple small aliquots to the defect. Note that all of the specific clinician work described in these codes must be performed, ie, they may not be altered to report these codes. Therefore, for the scenario presented, it would be appropriate to report code 17999, Unlisted procedure, skin, mucous membrane and subcutaneous tissue, because the work described in the scenario above differs from the procedures described by these codes. When reporting an unlisted code, it is necessary to submit supporting documentation (eg, procedure report) with the claim to provide an adequate description of the nature, extent, and need for the procedure and the time, effort, and equipment necessary to provide the service.

Other related CPT codes

15769 Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)

Procedure Code 15769 describes autologous soft tissue grafts (eg, fat, dermis, fascia, other soft tissues) that are harvested via direct excision from a donor site and then placed into a defect in a separate recipient site during the same operative session. Autologous soft tissue grafting involves a donor site, preparation of the graft, and a recipient site. Closure of the donor site is included in the work of code 15769. When these procedures are performed, they include local anesthesia.

The typical patient receiving this procedure would be treated in a facility setting. The site of service assignment, for both the facility and the outpatient office setting, is critical in preventing incorrect CPT code reporting. Therefore, this article clarifies that code 15769 is reported in a facility setting and may not be performed in an office setting. It is important to note that soft tissue or blood serum–based grafts harvested by other techniques (eg, venipuncture, aspiration, liposuction) and then injected are not reported with code 15769.

Reference : CPT assistant July & December 2023