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Coding Changes for 2020
New Codes for Fat Grafting

Autologous fat grafting was previously reported with CPT Code 20926 Tissue grafts, other (e.g. paratenon, fat, dermis). This code has been deleted and starting on January 1, 2020, will be replaced with five new codes to report these services based on anatomic site and volume.

CPT CodeCPT DescriptorCurrent Work RVUNEW Approved Work RVU
20926 Tissue grafts, other (e.g. paratenon, fat, dermis) 5.79 Code will be deleted
15769 Grafting of autologous soft tissue, other, harvested by direct excision (e.g. fat, dermis, fascia)   6.68
15771 Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms and/or legs; 50cc or less injectate   6.73
15772 Each additional 50cc injectate, or part thereof (List separately in addition to code for primary procedure)
(Use 15772 in conjunction with 15771)
  2.50
15773 Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands and/or feet; 25cc or less injectate   6.83
15774 Each additional 25cc injectate, or part thereof (List separately in addition to code for primary procedure)
(Use 15774 in conjunction with 15773)
  2.41

New Complex Repair Guidelines

Definitions for intermediate and complex repair of lacerations and wounds have been updated.

Simple repair is used when the wound is superficial; e.g. involving primarily epidermis or dermis, or subcutaneous tissues without significant involvement of deeper structures, and requires simple one layer closure. This includes local anesthesia and chemical or electrocauterization of wounds not closed.

Intermediate repair includes the repair of wounds that, in addition to the above, require layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin (epidermal and dermal) closure. It includes limited undermining (defined as a distance less than the maximum width of the defect, measured perpendicular to the closure line, along at least one entire edge of the defect). Single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.

Complex repair includes the repair of wounds that, in addition to the requirements for intermediate repair, require at least one of the following: exposure of bone, cartilage, tendon, or named neurovascular structure; debridement of wound edges (e.g. traumatic lacerations or avulsions), extensive undermining (defined as a distance greater than or equal to the maximum width of the defect, measured perpendicular to the closure line along at least on entire edge of defect); involvement of free margins of helical rim, vermilion border, or nostril rim; placement of retention sutures. Necessary preparation includes the creation of a limited defect for repairs or the debridement of complicated lacerations or avulsions. Complex repair does not include excision of benign (11400-11446) or malignant (11600-11646) lesions, excisional preparation of a wound bed (15002-15005) or debridement of an open fracture or open dislocation.