Graft

“My billing team and I have a difference of opinion. If we apply more than one graft, they have been using modifier -76. It is getting paid, but I am not sure that is the appropriate use of the modifier. I just assumed that we would bill for total units. However, each graft has a unit number. So, if we bill double the units, we need a way to alert the insurance company why the units are doubled. This is why we started using the 76 modifier. Any input would be appreciated.”

“I have a patient with a nonhealing pressure wound on his right ankle and his right heel. I applied a skin graft substitute to both sites. I used a single piece and shared it between the two sites. The ICD 10 code I used for the ankle is L89.513. The ICD 10 code I used for the heel is L89.613. For the application codes I utilized CPT 15271-RT to the L89.513 and CPT 15275-RT to the L89.613. The CCI does not show any conflict, but I am wondering whether a -51 is necessary. I also used the correct Q code for the product.”