CPT code 13122 is for complex repair of skin, subcutaneous tissue, and deeper structures, each additional 5 cm or less.
CPT code 13122 is used to describe a complex repair of the skin, subcutaneous tissue, or superficial fascia on the scalp, arms, and/or legs for each additional 5 centimeters or less. This code is typically used when the repair involves layered closure of deeper tissues and requires more intricate techniques than a simple or intermediate repair.
For CPT code 13122, 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 51 - Multiple Procedures: Indicates that multiple procedures were performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: Used when a procedure or service during the postoperative period was planned or anticipated.
4. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.
5. 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.
6. 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.
7. 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: Indicates an unplanned return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: Used when a procedure or service performed during the postoperative period is unrelated to the original procedure.
9. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was required during the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon was required during the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was required because a qualified resident surgeon was not available.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these specific non-physician practitioners assist in surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 13122 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, it is crucial to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 13122. Each MAC may have unique policies that influence how this code is processed and reimbursed.
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