CPT code 15175 is for the application of an acellular graft to the face, neck, hands, or feet, often used in reconstructive procedures.
CPT code 15175 is used to describe the application of an acellular graft to the face, neck, hands, or feet. This procedure involves placing a graft that does not contain any cells onto the specified area to aid in wound healing or reconstruction. The acellular graft serves as a scaffold for the patient's own cells to grow and regenerate the tissue.
For CPT code 15175, which pertains to the application of an acellular graft, 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. 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 if the procedure was planned or anticipated at the time of the original procedure, or if it is more extensive than the original 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 typically 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 the same procedure is repeated by the same provider.
7. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Applied 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): 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): Indicates that the procedure performed during the postoperative period was unrelated to the original procedure.
10. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required for the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Indicates that a minimum assistant surgeon was required for the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used when an assistant surgeon is necessary, and a qualified resident surgeon is not available.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): Applied when these non-physician practitioners assist in the surgery.
Each of these modifiers serves a specific purpose and should be used accurately to ensure proper billing and reimbursement.
The CPT code 15175 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates and guidelines for services covered under Medicare Part B.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and rates. Therefore, it is advisable to consult the relevant MAC for your area to obtain precise information regarding the reimbursement for CPT code 15175.
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