C5275 HCPCS - APPLICATION OF LOW COST SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA

Code Information

HCPCS Code: C5275
Sequence Number: 0010
Short Description: Low cost skin substitute app
Long Description: Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
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
ASC Payment Group Effective Date: 1/1/2014

Field Name	Field Value
Healthcare Common Procedure Coding System Code	C5275
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 face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
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 ASC Payment Group Code	YY
HCPCS ASC Payment Group Effective Date	1/1/2014
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