CPT code 14060 is used for tissue transfer or rearrangement of the eyelids, nose, ears, or lips for defects up to 10 square centimeters.
CPT code 14060 is used to describe a surgical procedure known as a tissue transfer or rearrangement. Specifically, this code applies to the transfer of tissue in the areas of the eyelids, nose, ears, or lips, and it covers a surface area of 10 square centimeters or less. This procedure is typically performed to repair defects or wounds in these sensitive and cosmetically important areas, ensuring both functional and aesthetic outcomes.
For CPT code 14060, which pertains to tissue transfer procedures, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Used 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 time.
2. Modifier 51 (Multiple Procedures): Applied when multiple procedures are performed during the same surgical session. This helps in indicating that the procedure was one of several performed.
3. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): Used if a subsequent procedure is planned or staged, or if it is more extensive than the original procedure.
4. Modifier 59 (Distinct Procedural Service): Indicates that a procedure or service was distinct or independent from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
5. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional): Used when the same procedure is repeated by the same provider.
6. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Applied when the same procedure is repeated by a different provider.
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): Used when a 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): Indicates that a procedure performed during the postoperative period was unrelated to the original procedure.
9. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required for the procedure.
10. Modifier 81 (Minimum Assistant Surgeon): Applied when an assistant surgeon is required for a minimal portion of the procedure.
11. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
12. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery): Indicates that a non-physician provider assisted in the surgery.
These modifiers help in providing additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 14060 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services and procedures covered by Medicare, and it is essential to verify the specific reimbursement rate for CPT code 14060 within this schedule.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the reimbursement for CPT code 14060. MACs are responsible for processing Medicare claims and can provide guidance on any local coverage determinations (LCDs) or specific documentation requirements that may affect reimbursement. Therefore, it is advisable to consult the relevant MAC for your region to ensure compliance with all Medicare guidelines and to confirm the exact reimbursement details for CPT code 14060.
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