CPT code 11441 is for the excision of a benign lesion on the face, measuring 0.6 to 1 cm, including margins.
CPT code 11441 is used for the excision of a benign (non-cancerous) lesion on the face, including the margins, with a diameter of 0.6 to 1.0 centimeters. This code is specifically for procedures where the lesion is removed surgically, ensuring that the surrounding tissue is also excised to achieve clear margins.
When using CPT code 11441, which pertains to the excision of benign lesions on the face with margins of 0.6 to 1 cm, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly greater effort than typically required. Documentation must support the substantial additional work.
2. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
- Apply this modifier if a significant, separately identifiable E/M service was performed by the same physician on the same day as the procedure.
3. Modifier 50 - Bilateral Procedure
- Use this modifier if the procedure was performed on both sides of the body.
4. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures, other than E/M services, are performed at the same session by the same provider.
5. Modifier 52 - Reduced Services
- Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
6. Modifier 59 - Distinct Procedural Service
- Apply this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day.
7. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Use this modifier if the procedure was repeated by the same physician or other qualified healthcare professional.
8. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Apply this modifier if the procedure was repeated by a different physician or other qualified healthcare professional.
9. 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 required an unplanned return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if an unrelated procedure or service was performed by the same physician during the postoperative period.
11. Modifier 80 - Assistant Surgeon
- Use this modifier if an assistant surgeon was required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier if a minimum assistant surgeon was required during the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier if an assistant surgeon was required because a qualified resident surgeon was not available.
14. Modifier 99 - Multiple Modifiers
- Apply this modifier if multiple modifiers are necessary to describe the service provided.
Each modifier serves a specific purpose and should be used in accordance with the clinical scenario and payer guidelines to ensure accurate billing and reimbursement.
The CPT code 11441 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS determines the payment rates for services provided by physicians and other healthcare professionals. To confirm the exact reimbursement rate and any additional requirements, healthcare providers should consult the MPFS directly.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in processing claims and providing guidance on Medicare coverage policies. Each MAC may have specific local coverage determinations (LCDs) that could affect the reimbursement of CPT code 11441. Therefore, it is advisable for healthcare providers to check with their respective MAC to ensure compliance with any local policies and to obtain the most accurate and up-to-date information regarding reimbursement.
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