CPT code 15336 is for applying an acellular graft to the face, neck, hands, or feet as an additional procedure.
CPT code 15336 is used for the application of a cellular graft to the face, neck, hands, or feet. This code specifically represents an additional procedure, meaning it is used when more than one graft is applied during the same session. Cellular grafts are often used to promote healing and tissue regeneration in areas that have been damaged or require reconstruction.
For CPT code 15336, 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
- Use this modifier if the application of the acellular graft is part of a staged or related procedure during the postoperative period.
2. Modifier 59 - Distinct Procedural Service
- Apply this modifier when the graft application is 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
- Use this modifier if the same procedure is repeated by the same provider.
4. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Apply this modifier if the 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
- Use this modifier if the patient returns to the operating room for a related procedure during the postoperative period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Apply this modifier if the procedure is unrelated to the original procedure during the postoperative period.
7. Modifier LT - Left Side (Used to identify procedures performed on the left side of the body)
- Use this modifier if the graft application is 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)
- Apply this modifier if the graft application is performed on the right side of the body.
9. Modifier 22 - Increased Procedural Services
- Use this modifier if the work required to perform the procedure is substantially greater than typically required.
10. Modifier 52 - Reduced Services
- Apply this modifier if the procedure is partially reduced or eliminated at the physician's discretion.
11. Modifier 53 - Discontinued Procedure
- Use this modifier if the procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
12. Modifier 62 - Two Surgeons
- Apply this modifier if two surgeons are required to perform the procedure.
13. Modifier 66 - Surgical Team
- Use this modifier if the procedure requires a surgical team.
14. 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
- Apply this modifier if the patient returns to the operating room for a related procedure during the postoperative period.
15. Modifier 80 - Assistant Surgeon
- Use this modifier if an assistant surgeon is required for the procedure.
16. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier if a minimum assistant surgeon is required for the procedure.
17. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier if an assistant surgeon is required and a qualified resident surgeon is not available.
18. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery
- Use this modifier if a PA, NP, or CNS assists in the surgery.
Each modifier serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 15336, which involves the application of an acellular graft, is subject to reimbursement by Medicare. To determine if this specific code is reimbursed, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates and coverage policies for various CPT codes. Additionally, it is essential to consult with the respective Medicare Administrative Contractor (MAC) for your region, as MACs are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement for CPT code 15336.
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