CPT code 15121 is for skin split autograft for face, neck, hands, feet, or genitalia, including additional areas.
CPT code 15121 is used for an additional split-thickness skin graft procedure on the face, neck, hands, feet, or genitalia. This code specifically applies to each additional 20 square centimeters or part thereof, beyond the initial area covered by the primary procedure code. It is typically used in cases where extensive skin grafting is required due to burns, trauma, or surgical removal of diseased tissue.
For CPT code 15121, which pertains to skin split autograft procedures, the following modifiers may be applicable:
1. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Used when a subsequent procedure is planned or anticipated during the postoperative period of the initial procedure.
2. Modifier 59 - Distinct Procedural Service
- Indicates that a procedure or service was distinct or independent from other services performed on the same day.
3. 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.
4. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Used when the same procedure is repeated by a different provider.
5. 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
- Indicates an unplanned return to the operating room for a related procedure during the postoperative period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Used when an unrelated procedure is performed by the same provider during the postoperative period of the initial procedure.
7. Modifier LT - Left Side (Used to identify procedures performed on the left side of the body)
- Indicates that the procedure was performed on the left side of the body.
8. Modifier RT - Right Side (Used to identify procedures performed on the right side of the body)
- Indicates that the procedure was performed on the right side of the body.
9. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service is substantially greater than typically required.
10. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
- Indicates that an evaluation and management service was performed during the postoperative period for a reason unrelated to the original procedure.
11. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
- Used when an evaluation and management service is performed on the same day as another procedure but is distinct and separately identifiable.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15121 is reimbursed by Medicare, but its reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any additional requirements, healthcare providers should consult the MPFS.
Additionally, it is important to verify coverage and payment details with the respective Medicare Administrative Contractor (MAC) for your region, as MACs may have localized policies and guidelines that affect reimbursement.
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