CPT code 12044 is for intermediate repair of non-hands/feet or genitalia, measuring 7.6 to 12.5 cm.
CPT code 12044 is used for the intermediate repair of wounds on the non-hair-bearing areas of the face, ears, eyelids, nose, lips, or genitals that are between 7.6 to 12.5 centimeters in length. This code indicates that the repair involves layered closure of one or more of the deeper layers of subcutaneous tissue and superficial fascia, in addition to the skin closure.
For CPT code 12044, which pertains to intermediate repair of non-face/non-genital areas measuring 7.6 to 12.5 cm, 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.
2. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service: Used when an E/M service is performed on the same day as the procedure.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same session by the same provider.
4. Modifier 52 - Reduced Services: Used 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.
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 provider.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Used when a procedure or service is repeated by a different provider.
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: Used when a related procedure is performed during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed during the postoperative period.
10. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Used 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.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines to ensure accurate billing and reimbursement.
The CPT code 12044 is reimbursed by Medicare, but the reimbursement amount can vary based on several factors. To determine the specific reimbursement rate, you would need to refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered by Medicare.
Additionally, the reimbursement can be influenced by the local policies of the Medicare Administrative Contractor (MAC) that services your geographic area. Each MAC may have specific guidelines and rates that apply to the CPT code 12044, so it is essential to consult the MAC's resources for the most accurate and up-to-date information.
Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 12044, and by individual payer. Don't let underpayments slip through the cracks—schedule a demo today to see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
