CPT code 14021 is used for tissue transfer procedures involving skin and/or subcutaneous tissue ranging from 10.1 to 30 square centimeters.
CPT code 14021 is used to describe a surgical procedure known as a tissue transfer or rearrangement. Specifically, this code applies when the surgeon moves tissue from one area of the body to another to cover a defect or wound that measures between 10.1 and 30 square centimeters. This type of procedure is often necessary to repair significant skin damage or to close a surgical site, ensuring proper healing and functionality.
When using CPT code 14021, which pertains to tissue transfer or rearrangement of the scalp, arms, and/or legs for a defect size of 10.1 to 30 square centimeters, 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. This could be due to increased complexity or difficulty of the case.
2. Modifier 51 (Multiple Procedures): Apply this modifier when multiple procedures are performed during the same surgical session. This helps indicate that more than one procedure was carried out.
3. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used if the procedure was planned or anticipated (staged), more extensive than the original procedure, or for therapy following a surgical procedure.
4. Modifier 59 (Distinct Procedural Service): Use this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day. This is particularly relevant if the procedures 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 if the same procedure is repeated by the same physician or healthcare professional.
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 healthcare professional.
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 if the patient needs to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Apply this modifier if 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 if 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 necessary 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.
The CPT code 14021 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates and any applicable modifiers that may affect reimbursement.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for this CPT code. It is essential for healthcare providers to consult their respective MACs to understand any regional variations or additional documentation requirements that may impact the reimbursement process for CPT code 14021.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 14021. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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
