CPT code 15335 is for applying an acellular graft to the face, neck, hands, or feet, aiding in wound healing and tissue regeneration.
CPT code 15335 is used for the application of an Acell graft to the face, neck, hands, or feet. This procedure involves placing a specialized graft material, known as Acell, onto these specific areas to promote healing and tissue regeneration. The graft helps in treating wounds, burns, or other conditions that require advanced wound care techniques.
For CPT code 15335, 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.
2. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service: Used when an E/M service is performed on the same day as the procedure.
3. Modifier 50 - Bilateral Procedure: Used when the procedure is performed on both sides of the body.
4. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same session.
5. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: Used when a procedure or service during the postoperative period was planned or anticipated.
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 provider.
8. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Used when a procedure or service is repeated by a different provider.
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 or service is performed by the same provider during the postoperative period.
11. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for 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 AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these professionals assist in the surgery.
15. Modifier LT - Left Side: Used to indicate the procedure was performed on the left side of the body.
16. Modifier RT - Right Side: Used to indicate the procedure was performed on the right side of the body.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 15335, "Apply acell graft f/n/hf/g," is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors. Primarily, the Medicare Physician Fee Schedule (MPFS) outlines the payment rates for services covered under Medicare Part B, including the application of acellular grafts.
However, the final decision on whether CPT code 15335 is reimbursed can also depend on the specific guidelines and policies set forth by the Medicare Administrative Contractor (MAC) for your region. MACs are responsible for processing Medicare claims and have the authority to establish local coverage determinations (LCDs) that can affect the reimbursement status of certain CPT codes. Therefore, it is essential to consult the MPFS and the relevant MAC's LCDs to determine if CPT code 15335 is reimbursed in your specific locality.
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