CPT code 12047 is for intermediate repair of non-hf/genital wounds greater than 30.0 cm.
CPT code 12047 is used to describe an intermediate repair of a non-horizontal facial or genital wound that is greater than 30.0 centimeters in length. This code is typically utilized by healthcare providers to document and bill for the specific procedure where a wound of significant size is repaired with layered closure, which involves suturing the deeper layers of tissue before closing the skin. This ensures proper healing and minimizes the risk of complications.
For CPT code 12047, which pertains to intermediate repair of non-hands/feet/genitalia wounds greater than 30.0 cm, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier when the work required to perform the procedure is substantially greater than typically required. This could be due to factors such as the complexity of the wound or the patient's condition.
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 evaluation and management (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 are performed during the same surgical session. This indicates that the procedure is one of several performed.
4. Modifier 52 - Reduced Services
- Use this modifier when the service or procedure is partially reduced or eliminated at the physician's discretion.
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 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
- 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 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
- Apply this modifier when a patient requires a return to the operating room for a related procedure during the postoperative period of the initial procedure.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional 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 during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier when a minimum assistant surgeon is required during 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 99 - Multiple Modifiers
- This modifier is used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement.
The CPT code 12047, which is categorized under intermediate repair procedures, 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 CPT codes, including 12047. Additionally, reimbursement can vary slightly depending on the region, as Medicare Administrative Contractors (MACs) may have localized adjustments. Therefore, it is advisable to consult the specific MAC for your region to obtain precise reimbursement details for CPT code 12047.
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