CPT code 15340 is used for applying a cultured skin substitute to a wound or burn, aiding in the healing process.
CPT code 15340 is used for the application of a skin substitute graft to a patient's wound or damaged skin area. This procedure involves placing a cultured skin substitute, which is typically grown in a lab, onto the affected area to promote healing and regeneration of the skin. This code is essential for accurate billing and documentation in healthcare settings, ensuring that providers are reimbursed for the specialized care they deliver.
For CPT code 15340, which pertains to the application of a cultured skin substitute, 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. This could be due to complications or other factors that increase the complexity of the procedure.
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 a significant, separately identifiable evaluation and management (E/M) service is performed by the same physician on the same day as the procedure.
3. Modifier 50 - Bilateral Procedure
- Used when the procedure is performed on both sides of the body during the same session.
4. Modifier 51 - Multiple Procedures
- Used when multiple procedures are performed during the same session. This modifier indicates that the procedures are distinct and separate.
5. Modifier 52 - Reduced Services
- Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
6. 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 (staged), more extensive than the original procedure, or for therapy following a surgical procedure.
7. 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.
8. 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 physician or other qualified healthcare professional subsequent to the original procedure or service.
9. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
10. 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 related procedure is performed during the postoperative period of the initial procedure.
11. 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 physician during the postoperative period.
12. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required during the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- Used when a minimum assistant surgeon is required during the procedure.
14. 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.
15. Modifier 99 - Multiple Modifiers
- Used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15340, which involves the application of a cultured skin substitute, is reimbursed by Medicare under specific conditions. To determine if this particular CPT code is covered, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services and procedures covered by Medicare. Additionally, it is essential to consult the local coverage determinations (LCDs) provided by the Medicare Administrative Contractor (MAC) for your region, as these contractors have the authority to establish coverage guidelines and reimbursement rates for specific services. By reviewing both the MPFS and the relevant MAC guidelines, providers can ascertain the reimbursement status and any specific requirements or limitations associated with CPT code 15340.
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