CPT CODES

CPT Code 15350

CPT code 15350 is a medical billing code used to describe the procedure of applying a skin homograft.

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What is CPT Code 15350

CPT code 15350 is used to describe the procedure of applying a skin homograft. A skin homograft involves transplanting skin from a donor to a recipient, typically to cover a wound or burn. This code is specifically used when the skin graft comes from a human donor, not from the patient themselves. The procedure helps in promoting healing and protecting the underlying tissues.

Does CPT 15350 Need a Modifier?

For CPT code 15350 (Skin homograft), the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or other factors that increased the complexity of the procedure.

2. Modifier 50 - Bilateral Procedure: If the skin homograft was performed on both sides of the body, this modifier should be used to indicate that the procedure was bilateral.

3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier should be used to indicate that more than one procedure was carried out.

4. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if the skin homograft is part of a staged procedure or if it is related to the initial procedure performed by the same physician during the postoperative period.

5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the skin homograft was a distinct procedural service from other services performed on the same day.

6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: If the skin homograft needs to be repeated by the same provider, this modifier should be used.

7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Use this modifier if the skin homograft 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: This modifier is 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: If the skin homograft is performed during the postoperative period of another procedure but is unrelated to the initial procedure, this modifier should be used.

10. Modifier 80 - Assistant Surgeon: If an assistant surgeon was required for the skin homograft, this modifier should be used.

11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required for the procedure.

12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.

13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Use this modifier if a non-physician provider assisted in the surgery.

Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the services provided.

CPT Code 15350 Medicare Reimbursement

The CPT code 15350 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS).

The MPFS provides detailed information on the payment rates for services covered under Medicare Part B. Additionally, the reimbursement for CPT code 15350 may vary depending on the local coverage determinations (LCDs) set by the Medicare Administrative Contractor (MAC) for your region.

It is essential to consult the MPFS and your regional MAC to understand the specific reimbursement criteria and any potential limitations or requirements for this CPT code.

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