CPT code 11901 is for the injection of more than seven skin lesions.
CPT code 11901 is used to describe the procedure of injecting medication into more than seven skin lesions. This code is typically utilized by healthcare providers to document and bill for the treatment of multiple skin conditions, such as warts, cysts, or other dermatological issues, where medication is directly injected into the affected areas.
For CPT code 11901, which pertains to the injection of more than seven skin lesions, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified healthcare professional on the same day of the procedure or other service. This modifier is used when an E/M service is provided on the same day as the injection procedure, and the E/M service is distinct and separately identifiable from the procedure.
2. Modifier 50: Bilateral procedure. This modifier is used if the injections are performed on both sides of the body.
3. Modifier 51: Multiple procedures. This modifier is used when multiple procedures, other than E/M services, are performed at the same session by the same provider.
4. Modifier 59: Distinct procedural service. This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 76: Repeat procedure or service by the same physician or other qualified healthcare professional. This modifier is used if the same procedure is repeated on the same day by the same provider.
6. Modifier 77: Repeat procedure by another physician or other qualified healthcare professional. This modifier is used if the same procedure is repeated on the same day by a different provider.
7. Modifier 78: Unplanned return to the operating/procedure room by the same physician or other qualified healthcare professional following initial procedure for a related procedure during the postoperative period. This modifier is used if the patient needs to return for a related procedure during the postoperative period.
8. Modifier 79: Unrelated procedure or service by the same physician or other qualified healthcare professional during the postoperative period. This modifier is used if an unrelated procedure is performed during the postoperative period of the initial procedure.
9. Modifier LT: Left side. This modifier is used to specify that the procedure was performed on the left side of the body.
10. Modifier RT: Right side. This modifier is used to specify that 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 11901, which involves the injection of more than seven skin lesions, is reimbursed by Medicare. To determine the specific reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for various services covered by Medicare. Additionally, reimbursement may vary slightly depending on the region, as Medicare Administrative Contractors (MACs) are responsible for processing claims and setting local coverage determinations. It is advisable to consult the relevant MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 11901.
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