CPT code 15155 is for a cultured skin graft for the face, neck, hands, or feet, used in medical billing to specify this particular procedure.
CPT code 15155 is used for the procedure involving a cultured skin graft for the face, neck, hands, or feet. This code specifically refers to the application of a skin graft that has been grown in a laboratory setting, which is then used to cover and heal areas on these sensitive and functionally important parts of the body. This type of graft is often utilized in cases where natural skin regeneration is insufficient, such as in severe burns or extensive wounds.
Certainly! Here are the modifiers that could be used with CPT code 15155:
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 52 - Reduced Services
- Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. 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.
6. 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.
7. 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.
8. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Used when a procedure or service is repeated by another physician.
9. 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 patient returns to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Used when an unrelated procedure is performed by the same physician during the postoperative period.
11. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon
- Used when a minimum assistant surgeon is required during the procedure.
13. 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.
14. Modifier 99 - Multiple Modifiers
- Used when two or more modifiers are necessary to describe the service.
These modifiers help provide additional information about the performed procedure and ensure accurate billing and reimbursement.
When determining if CPT code 15155 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the Medicare Administrative Contractor (MAC) for your specific region. The MPFS is a comprehensive listing of the maximum fees Medicare will pay for various services, and it is updated annually.
To verify if CPT code 15155 is reimbursed, you would need to check the MPFS for the current year. Additionally, MACs, which are private health care insurers that have been awarded a geographic jurisdiction to process Medicare Part A and Part B medical claims, may have specific local coverage determinations (LCDs) that affect reimbursement. These LCDs can provide additional details on whether a particular service, such as the one represented by CPT code 15155, is covered and under what conditions.
Therefore, to determine if CPT code 15155 is reimbursed by Medicare, you should review the MPFS and consult the relevant MAC's guidelines for your area.
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