CPT code 12032 is for intermediate repair of skin, subcutaneous tissue, and/or fascia for wounds 2.6 to 7.5 cm in length.
CPT code 12032 is used for intermediate repair of superficial wounds on the scalp, arms, trunk, and/or extremities that are between 2.6 to 7.5 centimeters in length. This code indicates that the procedure involves more than a simple closure, requiring layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin closure.
For CPT code 12032, which pertains to intermediate repair of wounds, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the work required to perform the procedure is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service): This modifier is used when a significant, separately identifiable E/M service is performed by the same physician on the same day as the procedure.
3. 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. This helps indicate that the procedure is one of several performed.
4. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): Use this modifier if the procedure was planned or anticipated (staged), more extensive than the original procedure, or for therapy following a surgical procedure.
5. 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. It is often used to identify procedures that are not normally reported together but are appropriate under the circumstances.
6. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional): Use this modifier 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): This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
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): Apply this modifier when a related procedure requires a return to the operating room during the postoperative period of the initial procedure.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Use this modifier 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): This modifier is used when an assistant surgeon is required for the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Apply this modifier when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Use this modifier when an assistant surgeon is required, and a qualified resident surgeon is not available.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery): This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement. Proper documentation is essential to support the use of any modifier.
The CPT code 12032, which refers to intermediate repair of wounds, is reimbursed by Medicare. To determine the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered by Medicare. Additionally, the specific reimbursement amount can vary based on the locality, as determined by the Medicare Administrative Contractor (MAC) responsible for the region. It is essential for providers to consult the MPFS and their respective MAC to obtain accurate and up-to-date reimbursement information for CPT code 12032.
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