CPT code 13132 is for complex repair of the face, chin, cheek, mouth, neck, axillae, genitalia, hands, or feet.
CPT code 13132 is used for a complex repair of wounds on the face, ears, eyelids, nose, lips, and/or mucous membranes. This code specifically applies to repairs that require layered closure of one or more of these areas, typically involving deeper structures such as the dermis and possibly the subcutaneous tissues. The complexity of the repair often necessitates meticulous technique to ensure proper healing and cosmetic outcome.
Certainly! Below is a list of modifiers that could be used with CPT code 13132, along with the reasons for each:
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 increased complexity or difficulty of the repair.
2. Modifier 52 - Reduced Services
- Apply this modifier when the procedure is partially reduced or eliminated at the physician's discretion. This might occur if the full extent of the repair was not necessary.
3. 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) at the time of the original procedure, or if it is more extensive than the original procedure, or for therapy following a surgical procedure.
4. 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.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Apply this modifier when the same procedure is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Use this modifier when the same procedure is repeated by a different physician or other qualified healthcare professional subsequent to the original procedure.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- This modifier is used when a related procedure is performed during the postoperative period of the initial procedure, requiring a return to the operating room.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier when an unrelated procedure or service is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 80 - Assistant Surgeon
- Use this modifier when an assistant surgeon is required for the procedure.
10. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier when a minimum assistant surgeon is required for the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier when an assistant surgeon is required because a qualified resident surgeon is not available.
12. 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.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
Determining whether CPT code 13132 is reimbursed by Medicare involves consulting the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by the Medicare Administrative Contractor (MAC) for your specific region. The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding reimbursement rates.
To verify if CPT code 13132 is reimbursed, you should:
1. Check the MPFS: Access the MPFS database through the Centers for Medicare & Medicaid Services (CMS) website. Enter CPT code 13132 to see if it is listed and review the associated reimbursement details.
2. Consult Your MAC: Each MAC may have specific guidelines and coverage determinations that can affect reimbursement. Contact your regional MAC or visit their website to confirm if CPT code 13132 is covered and to understand any additional requirements or documentation needed for reimbursement.
By following these steps, you can determine if CPT code 13132 is reimbursed by Medicare and ensure compliance with all relevant guidelines.
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