CPT CODES

CPT Code 15276

CPT code 15276 is for an additional skin substitute graft applied to the face, neck, hands, or feet.

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What is CPT Code 15276

CPT code 15276 is used to describe the application of a skin substitute graft to the face, neck, hands, feet, or genitalia for each additional 25 square centimeters or part thereof. This code is typically used in medical billing to indicate that a healthcare provider has performed a procedure involving the placement of a skin graft in these specific areas of the body, beyond the initial 25 square centimeters covered by the primary code.

Does CPT 15276 Need a Modifier?

For CPT code 15276, 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 an unplanned 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 a procedure is performed during the postoperative period of another procedure, but is unrelated to 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 50 - Bilateral Procedure
- Used when the same procedure is performed on both sides of the body during the same operative session.

10. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service is substantially greater than typically required.

11. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
- Used when an evaluation and management service is performed during the postoperative period for a reason unrelated to the original procedure.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 15276 Medicare Reimbursement

The CPT code 15276 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your local Medicare Administrative Contractor (MAC). The MPFS provides detailed information on the reimbursement rates for various CPT codes, including 15276. Additionally, MACs may have specific guidelines or requirements that could affect reimbursement. Therefore, healthcare providers should consult both the MPFS and their respective MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 15276.

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