CPT code 15004 is for wound preparation on the face, neck, hands, or feet, involving cleaning and preparing the wound for further treatment.
CPT code 15004 is used for the preparation of a wound on the face, neck, hands, feet, or genitalia. This code specifically refers to the surgical preparation of a wound that requires a more complex procedure, such as the removal of damaged tissue or the creation of a clean wound bed, to facilitate healing or to prepare for a skin graft or other reconstructive procedure.
For CPT code 15004, which pertains to wound preparation, the following modifiers may be applicable:
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 the complexity of the wound or additional time and effort needed.
2. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
- Apply this modifier if a significant, separately identifiable evaluation and management (E/M) service is performed by the same physician on the same day as the wound preparation.
3. Modifier 50 - Bilateral Procedure
- Use this modifier if the wound preparation is performed on both sides of the body (bilaterally).
4. Modifier 51 - Multiple Procedures
- This modifier is used when multiple procedures, other than E/M services, are performed at the same session by the same provider.
5. Modifier 59 - Distinct Procedural Service
- Apply this modifier to indicate that the wound preparation is a distinct procedural service from other services performed on the same day.
6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Use this modifier if the wound preparation procedure is repeated by the same physician or other qualified healthcare professional.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- This modifier is used when the wound preparation procedure is repeated by a different physician or other qualified healthcare professional.
8. 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
- Apply this modifier if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Use this modifier if an unrelated procedure or service is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required during the wound preparation procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier if a minimum assistant surgeon is required during the procedure.
12. 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.
13. 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 wound preparation procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15004 is reimbursed by Medicare, but it is essential to verify its specific reimbursement status through the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered under Medicare Part B. Additionally, reimbursement can vary based on the local policies set by the Medicare Administrative Contractor (MAC) for your region. Therefore, it is advisable to consult the MPFS and your local MAC to confirm the exact reimbursement details for CPT code 15004.
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