CPT code 14301 is used for tissue transfer procedures covering an area of 30.1 to 60 square centimeters.
CPT code 14301 is used to describe a tissue transfer procedure where a surgeon moves tissue from one part of the body to another to cover a defect or wound. Specifically, this code applies when the area of tissue being transferred is between 30.1 and 60 square centimeters. This type of procedure is often necessary for reconstructive purposes, such as after the removal of a tumor or to repair a significant injury.
When using CPT code 14301, which pertains to tissue transfer for any area between 30.1 to 60 square centimeters, 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. This could be due to complications or additional time and effort.
2. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same surgical session. This helps in indicating that the procedure is one of several performed.
3. Modifier 59 - Distinct Procedural Service: Used to identify procedures/services that are not normally reported together but are appropriate under the circumstances. This modifier indicates that the procedures are distinct and independent from other services provided on the same day.
4. 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 subsequent to the original procedure.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Applied when a procedure or service is repeated by a different provider than the one who performed the original procedure.
6. 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 when a patient requires a return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: Applied when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
8. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
9. Modifier 81 - Minimum Assistant Surgeon: Applied when an assistant surgeon is required for a minimal portion of the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required, and a qualified resident surgeon is not available.
11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these non-physician practitioners assist in 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 14301, which involves a specific medical procedure, is reimbursed by Medicare under certain conditions. To determine if this code is reimbursed, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered by Medicare.
Additionally, it is essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they administer Medicare claims and can provide specific guidance on coverage and reimbursement criteria for CPT code 14301. The MACs may have local coverage determinations (LCDs) that further define the circumstances under which this code is reimbursed.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and identify underpayments down to the CPT code level, including specific codes like 14301. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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