CPT code 15271 is used for billing skin substitute grafts applied to the trunk, arms, or legs in medical procedures.
CPT code 15271 is used to describe the application of a skin substitute graft to the trunk, arms, or legs. This procedure involves placing a graft made from either synthetic or biological materials onto a wound or damaged area of the skin to promote healing and tissue regeneration. This code specifically applies to the initial 25 square centimeters or less of the treated area.
For CPT code 15271, which pertains to skin substitute grafts for the trunk, arms, or legs, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service. This modifier is used when an E/M service is provided on the same day as the skin graft procedure and is distinct from the procedure itself.
2. Modifier 50: Bilateral procedure. This modifier is used if the skin graft procedure is performed on both sides of the body (e.g., both arms or both legs).
3. Modifier 51: Multiple procedures. This modifier is used when multiple procedures, including the skin graft, are performed during the same surgical session.
4. Modifier 58: Staged or related procedure or service by the same physician during the postoperative period. This modifier is used if the skin graft procedure is planned or staged as part of a series of procedures.
5. Modifier 59: Distinct procedural service. This modifier is used to indicate that the skin graft procedure is distinct or independent from other services performed on the same day.
6. Modifier 76: Repeat procedure or service by the same physician. This modifier is used if the skin graft procedure needs to be repeated by the same physician.
7. Modifier 77: Repeat procedure by another physician. This modifier is used if the skin graft procedure is repeated by a different physician.
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. This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. This modifier is used if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80: Assistant surgeon. This modifier is used if an assistant surgeon is required during the skin graft procedure.
11. Modifier 81: Minimum assistant surgeon. This modifier is used if a minimum assistant surgeon is required during the skin graft procedure.
12. Modifier 82: Assistant surgeon (when qualified resident surgeon not available). This modifier is used if 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. This modifier is used if a non-physician provider assists in the surgery.
These modifiers help provide additional information about the circumstances under which the skin graft procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15271, which involves a specific medical procedure, is reimbursed by Medicare. To determine the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B. Additionally, it's important to consult with your regional Medicare Administrative Contractor (MAC) for any specific local coverage determinations or additional guidelines that may affect reimbursement for CPT code 15271.
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