CPT code 15275 is for skin substitute grafts applied to the face, neck, hands, or feet, aiding in wound healing and tissue repair.
CPT code 15275 is used to describe the procedure of applying a skin substitute graft to the face, neck, hands, or feet. This code is specifically for the first 25 square centimeters or less of the graft. Skin substitute grafts are often used to treat wounds, burns, or other conditions where the skin needs to be replaced or repaired. This procedure involves placing a synthetic or biological material over the affected area to promote healing and protect the underlying tissues.
For CPT code 15275, the following modifiers may be applicable:
1. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Used when a subsequent procedure is planned or anticipated and is related to the initial procedure.
2. 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.
3. 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.
4. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Used when the same procedure is repeated by a different provider.
5. 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.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Used when an unrelated procedure is performed by the same provider during the postoperative period of the initial procedure.
7. Modifier LT - Left Side (Used to identify procedures performed on the left side of the body)
- Used to specify that the procedure was performed on the left side of the body.
8. Modifier RT - Right Side (Used to identify procedures performed on the right side of the body)
- Used to specify that the procedure was performed on the right side of the body.
9. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service is substantially greater than typically required.
10. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
- Used when a significant, separately identifiable E/M service is performed by the same provider on the same day as the procedure.
11. Modifier 50 - Bilateral Procedure
- Used when the same procedure is performed on both sides of the body during the same operative session.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15275 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, including the associated payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have different guidelines and fee schedules. Therefore, it is advisable to consult the relevant MAC for your area to obtain precise information on the reimbursement for CPT code 15275.
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