CPT code 15342 is for a cultured skin graft procedure covering 25 square centimeters.
CPT code 15342 is used to describe a medical procedure involving the application of a cultured skin graft to a 25 square centimeter area of the body. This code is specifically for instances where skin cells have been grown in a laboratory setting and then transplanted to the patient to aid in wound healing or skin regeneration.
For CPT code 15342, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Used when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the procedure.
2. Modifier 50 (Bilateral Procedure): Applied if the cultured skin graft is performed on both sides of the body during the same operative session.
3. Modifier 51 (Multiple Procedures): Used when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
4. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): Used if the cultured skin graft is part of a staged or related procedure during the postoperative period of the initial surgery.
5. Modifier 59 (Distinct Procedural Service): Applied to indicate that the procedure is distinct or independent from other services performed on the same day. This is used to avoid bundling issues.
6. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional): Used if the same procedure is repeated by the same provider.
7. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Applied if the same procedure is repeated by a different provider.
8. 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 if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Applied if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required for the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Applied when a minimum assistant surgeon is required for the procedure.
12. 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.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): Applied when a non-physician provider assists in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 15342, which involves a cultured skin graft of 25 cm, is reimbursed by Medicare. To determine the specific reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for various services covered by Medicare. Additionally, it is important to consult with your local Medicare Administrative Contractor (MAC) for any region-specific guidelines or variations in reimbursement policies. The MACs are responsible for processing Medicare claims and can provide further clarification on coverage and payment for CPT code 15342.
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