CPT code 14040 is a medical billing code for tissue transfer procedures involving the face, cheeks, chin, mouth, neck, axilla, or groin.
CPT code 14040 is used for the surgical procedure known as a tissue transfer or rearrangement. Specifically, this code applies to the transfer of tissue from the face, cheeks, chin, mouth, neck, axillae (armpits), genitalia, hands, and/or feet. This procedure is typically performed to repair defects or injuries in these areas, often involving the movement of skin and underlying tissues to cover a wound or surgical site, ensuring proper healing and functionality.
For CPT code 14040, 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 50 - Bilateral Procedure
- Indicates that the procedure was performed on both sides of the body.
3. Modifier 51 - Multiple Procedures
- Used when multiple procedures are performed during the same session.
4. Modifier 52 - Reduced Services
- Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
- Used for a planned or anticipated procedure that follows the initial procedure.
6. Modifier 59 - Distinct Procedural Service
- Indicates that a procedure or service was distinct or independent from other services performed on the same day.
7. 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.
8. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Indicates that a procedure or service is repeated by a different provider.
9. 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
- Used for an unplanned return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that a procedure or service performed during the postoperative period was unrelated to the original procedure.
11. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon
- Indicates that a minimum assistant surgeon was required.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
14. Modifier 99 - Multiple Modifiers
- Indicates that multiple modifiers are applicable to the procedure.
Each of these modifiers serves a specific purpose and should be used according to the specific circumstances of the procedure to ensure accurate billing and reimbursement.
The CPT code 14040 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable coverage limitations, healthcare providers should refer to the MPFS, which provides detailed information on payment rates for services covered by Medicare.
Additionally, it is important to consult with the relevant Medicare Administrative Contractor (MAC) for your region. MACs are responsible for processing Medicare claims and can provide specific guidance on whether CPT code 14040 is covered under particular circumstances, as well as any documentation requirements that must be met for reimbursement. Each MAC may have slightly different policies, so it is crucial to verify this information with the appropriate contractor.
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