CPT code 11920 is for correcting skin color in an area 6.0 cm or smaller.
CPT code 11920 is used for the correction of skin color defects, specifically for areas that are 6.0 cm or less in size. This procedure typically involves techniques such as tattooing or micropigmentation to match the skin color and improve the appearance of the affected area.
For CPT code 11920, which pertains to the correction of skin color for an area of 6.0 cm or less, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or other factors that increased the complexity of the procedure.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be appended to indicate that it was a bilateral procedure.
3. Modifier 51 - Multiple Procedures: If multiple procedures were performed during the same session, this modifier should be used to indicate that more than one procedure was carried out.
4. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier should be used.
7. Modifier 77 - Repeat Procedure by Another Physician: If the procedure is repeated by a different physician, this modifier should be appended.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon was necessary for the procedure, this modifier should be used.
11. Modifier 81 - Minimum Assistant Surgeon: This modifier is used if a minimum assistant surgeon was required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier if an assistant surgeon was necessary because a qualified resident surgeon was not available.
13. Modifier 99 - Multiple Modifiers: If multiple modifiers are necessary, this modifier should be used to indicate that more than one modifier applies to the procedure.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
CPT code 11920 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services covered by Medicare, including the associated reimbursement rates.
Additionally, MACs are responsible for processing Medicare claims and can offer region-specific guidance on coverage and reimbursement policies. Therefore, while CPT code 11920 is generally reimbursable, consulting the MPFS and your MAC will ensure accurate and up-to-date information tailored to your practice's location.
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