CPT code 15120 is for a skin split autograft procedure on the face, neck, hands, or feet, used in medical billing to describe this specific service.
CPT code 15120 is used for a skin split autograft procedure on the face, neck, hands, or feet. This code specifically refers to the surgical process where a thin layer of skin is taken from one part of the patient's body (the donor site) and grafted onto another area that has been damaged or needs reconstruction. This type of graft is commonly used to treat burns, injuries, or surgical wounds that require skin coverage to promote healing and restore function.
For CPT code 15120, 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 complications or other factors that increase the complexity of the procedure.
2. Modifier 50 (Bilateral Procedure): Applied when the procedure is performed on both sides of the body during the same operative session.
3. Modifier 51 (Multiple Procedures): Used when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
4. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): Used when a subsequent procedure is planned or anticipated and is related to the initial procedure.
5. Modifier 59 (Distinct Procedural Service): Indicates that the procedure is distinct or independent from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
6. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional): Applied when the same procedure is repeated by the same provider.
7. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Used when the same procedure is repeated by a different provider.
8. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): Indicates an unplanned return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Used when an unrelated procedure is performed by the same provider during the postoperative period of the initial procedure.
10. Modifier 80 (Assistant Surgeon): Indicates that an assistant surgeon was necessary for the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Used when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Applied 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): Indicates that a non-physician provider assisted in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 15120 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS).
The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding reimbursement rates.
Additionally, the reimbursement for CPT code 15120 may vary depending on the local policies set by the Medicare Administrative Contractor (MAC) for your region.
It is essential to consult the MPFS and your local MAC guidelines to determine the exact reimbursement details and any additional requirements that may apply.
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