CPT code 12014 is for the repair of superficial wounds on the face, ears, eyelids, nose, lips, or mouth, measuring 5.1 to 7.5 cm.
CPT code 12014 is used to describe the repair of superficial wounds on the face, ears, eyelids, nose, lips, or mucous membranes that are between 5.1 and 7.5 centimeters in length. This code is specifically for simple repairs, which typically involve suturing the skin and ensuring proper alignment for healing.
For CPT code 12014, which pertains to the repair of a specific anatomical area within a specified size range, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Used when the work required to provide a service is substantially greater than typically required. This could be due to factors such as increased complexity or time.
2. Modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service): Applied when a significant, separately identifiable evaluation and management (E/M) service is performed by the same physician on the same day as the procedure.
3. Modifier 51 (Multiple Procedures): Used when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
4. Modifier 52 (Reduced Services): Applied when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 (Distinct Procedural Service): Used to indicate that a procedure or service was distinct or independent from other services performed on the same day. This is often used to identify procedures that are not typically reported together but are appropriate under the circumstances.
6. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional): Used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
7. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Applied when a procedure or service is repeated by another physician or qualified healthcare professional subsequent to the original procedure or service.
8. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period): Used when a patient requires a return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period): Applied when an unrelated procedure or service is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required during the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Applied when a minimum assistant surgeon is required during the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used when an assistant surgeon is required and a qualified resident surgeon is not available.
13. Modifier 99 (Multiple Modifiers): Used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 12014 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates.
Additionally, the reimbursement for CPT code 12014 may vary depending on the local policies and guidelines set by the Medicare Administrative Contractor (MAC) for your region. It is essential to verify with your MAC to ensure compliance with any regional variations or additional documentation requirements that may affect reimbursement.
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