C5274 HCPCS - APPLICATION OF LOW COST SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; EACH ADDITIONAL 100 SQ CM WOUND SURFACE AREA, OR PART THEREOF, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND CHILDREN, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

Code Information

HCPCS Code: C5274
Sequence Number: 0010
Short Description: Low cost skin substitute app
Long Description: Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
Date Added: 1/1/2014
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2014
Classification: Temporary Hospital Outpatient Prospective Payment System
Coding System: HCPCS

Berenson-Eggers Type Of Service Code: P5A - Ambulatory procedures - skin
Type Of Service Code:
- 2 - Surgery
- F - Ambulatory surgical center (facility usage for surgical services)

Pricing Indicator Code:
- 53 - Statute
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: D - Special coverage instructions apply

Field Name	Field Value
Healthcare Common Procedure Coding System Code	C5274
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
HCPCS Short Description	Low cost skin substitute app
HCPCS Pricing Indicator Code 1	53 - Statute
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Statute Number	1833(t)
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Berenson-Eggers Type Of Service Code	P5A - Ambulatory procedures - skin
HCPCS Type Of Service Code 1	2 - Surgery
HCPCS Type Of Service Code 2	F - Ambulatory surgical center (facility usage for surgical services)
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/2014
HCPCS Action Effective Date	1/1/2014
HCPCS Action Code	N - No maintenance for this code