CPT code 15420 is used for applying a skin graft to the face, neck, hands, or feet, essential for accurate medical billing and documentation.
CPT code 15420 is used for the application of a skin graft to the face, neck, hands, or feet. This procedure involves transplanting skin from one area of the body to another to repair or replace damaged or missing skin in these specific regions. The code is typically used in cases where the skin has been lost due to injury, surgery, or disease, and the graft helps to promote healing and restore function and appearance.
For CPT code 15420, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): This modifier is used when the work required to provide a service is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 50 (Bilateral Procedure): This modifier is used when the procedure is performed on both sides of the body during the same operative session.
3. Modifier 51 (Multiple Procedures): This modifier is used when multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed.
4. Modifier 52 (Reduced Services): This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): This modifier is 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.
6. Modifier 59 (Distinct Procedural Service): This modifier is 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): This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
8. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
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): This modifier is used when a related procedure is performed during the postoperative period of the initial procedure.
10. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used when an unrelated procedure or service is performed by the same physician during the postoperative period of the initial procedure.
11. Modifier 80 (Assistant Surgeon): This modifier is used when an assistant surgeon is required during the procedure.
12. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when a minimum assistant surgeon is required during the procedure.
13. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): This modifier is used when an assistant surgeon is required and a qualified resident surgeon is not available.
14. Modifier 99 (Multiple Modifiers): This modifier is used when two or more modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement. Proper documentation is essential to support the use of any modifier.
The CPT code 15420, which involves the application of a skin graft, 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) as they are responsible for processing Medicare claims and can provide region-specific information regarding coverage and reimbursement for CPT code 15420.
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