CPT code 15136 is for an additional dermal autograft procedure on the face, neck, hands, or feet.
CPT code 15136 is used for a procedure involving a dermal autograft, which is a type of skin graft where the skin is taken from one part of the patient's body and transplanted to another part. Specifically, this code applies to grafts on the face, neck, hands, or feet, and it is used for additional areas beyond the initial graft site. This code helps healthcare providers accurately document and bill for the complexity and extent of the grafting procedure.
Certainly! Here are the modifiers that could be used with CPT code 15136:
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 helps in indicating 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 procedure or service during the postoperative period was planned or anticipated (staged), more extensive than the original procedure, or for therapy following a surgical procedure.
5. 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 used to identify procedures that are not normally reported together but are appropriate under the circumstances.
6. 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 physician or other qualified healthcare professional subsequent to the original procedure or service.
7. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Applied when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
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): Used when a related procedure is performed during the postoperative period of the initial procedure.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period): Indicates that an unrelated procedure or service was performed by the same physician during the postoperative period.
10. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required during the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Applied when a minimum assistant surgeon is required during the procedure.
12. 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.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery): Indicates that a physician assistant, nurse practitioner, or clinical nurse specialist provided services as an assistant at 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 15136 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable guidelines, healthcare providers should refer to the MPFS, which provides detailed information on the payment rates for various services.
Additionally, it is important to consult with the Medicare Administrative Contractor (MAC) for your region, as they are responsible for processing Medicare claims and can provide further clarification on coverage and reimbursement specifics for CPT code 15136.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can read your contracts and detect underpayments down to the CPT code level, including specific codes like 15136, and by individual payer. Don't let underpayments slip through the cracks—schedule a demo today to see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
