CPT code 11056 is used for trimming 2 to 4 skin lesions.
CPT code 11056 is used to describe the medical procedure for trimming skin lesions, specifically when the number of lesions being treated ranges from 2 to 4. This code is utilized by healthcare providers to document and bill for the service of removing excess skin growths or lesions, ensuring accurate and standardized reporting for insurance claims and medical records.
For CPT code 11056, which pertains to the trimming of skin lesions (2 to 4), the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service. Use this modifier if an E/M service was provided in addition to the trimming of skin lesions.
2. Modifier 50: Bilateral procedure. Use this modifier if the procedure was performed on both sides of the body.
3. Modifier 51: Multiple procedures. Use this modifier if multiple procedures were performed during the same session.
4. Modifier 59: Distinct procedural service. Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
5. Modifier 76: Repeat procedure or service by the same physician. Use this modifier if the same procedure was repeated on the same day by the same physician.
6. Modifier 77: Repeat procedure by another physician. Use this modifier if the same procedure was repeated on the same day by a different physician.
7. Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period. Use this modifier if the patient had to return for an unplanned related procedure.
8. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if an unrelated procedure was performed during the postoperative period of the initial procedure.
9. Modifier LT: Left side. Use this modifier if the procedure was performed on the left side of the body.
10. Modifier RT: Right side. Use this modifier if the procedure was performed on the right side of the body.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 11056 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, reimbursement for CPT code 11056 may vary depending on the local policies of the Medicare Administrative Contractor (MAC) that services your region. Each MAC has the authority to make determinations on coverage and payment for services within their jurisdiction, so it is advisable to consult the specific MAC guidelines to ensure accurate billing and reimbursement.
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