CPT code 15152 is used for cultured skin grafts, indicating the application of a tissue-cultured skin substitute to a wound or lesion.
CPT code 15152 is used to describe the procedure of applying a cultured skin graft to areas such as the trunk, arms, or legs. This code specifically covers the application of a skin graft that has been grown in a laboratory setting, which is then used to cover and heal wounds or burns on these parts of the body. The "+%" indicates that this code is used for each additional 1 percent of body area treated beyond the initial area covered by the primary code.
For CPT code 15152, 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.
2. Modifier 50 - Bilateral Procedure
- Used when the procedure is performed on both sides of the body.
3. Modifier 51 - Multiple Procedures
- Used when multiple procedures are performed during the same session.
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 staged during the postoperative period of the initial procedure.
5. Modifier 59 - Distinct Procedural Service
- Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
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.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Used when a procedure or service is repeated by another physician or other qualified health care professional.
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
- 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 During the Postoperative Period
- Used when an unrelated procedure or service is 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
- Used 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 91 - Repeat Clinical Diagnostic Laboratory Test
- Used when a clinical diagnostic laboratory test is repeated.
14. Modifier LT - Left Side (used to identify procedures performed on the left side of the body)
- Used to indicate that the procedure was performed on the left side of the body.
15. Modifier RT - Right Side (used to identify procedures performed on the right side of the body)
- Used to indicate that the procedure was performed on the right side of the body.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15152 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and coverage details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services covered by Medicare, and these rates can vary based on geographic location and other factors.
Additionally, it is advisable to consult with your local Medicare Administrative Contractor (MAC) for any region-specific guidelines or additional requirements that may impact reimbursement for CPT code 15152. The MACs are responsible for processing Medicare claims and can provide detailed information on coverage policies and billing instructions.
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