CPT Code 15431
CPT code 15431 is used for applying an acellular xenograft, an additional procedure often used in wound care or reconstructive surgery.
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What is CPT Code 15431
CPT code 15431 is used to describe the application of an acellular xenograft, which is a type of skin graft derived from a different species, such as pig or cow, that has had all its cellular components removed. This code specifically refers to an additional area of application, meaning it is used when the graft is applied to an area beyond the initial site covered by the primary code. This procedure is typically used to promote wound healing and tissue regeneration in patients with severe burns, chronic wounds, or other significant skin injuries.
Does CPT 15431 Need a Modifier?
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CPT Code 15431 Medicare Reimbursement
The CPT code 15431, which involves the application of an acellular xenograft, 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 policies and guidelines that may affect reimbursement. By reviewing both the MPFS and the relevant MAC's LCDs, providers can ascertain whether CPT code 15431 is reimbursed and under what circumstances.
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