CPT CODES

CPT Code 15570

CPT code 15570 is a medical billing code used to describe a surgical procedure involving a skin pedicle flap on the trunk.

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What is CPT Code 15570

CPT code 15570 is used to describe a surgical procedure where a skin pedicle flap is created on the trunk of the body. This involves lifting a section of skin and underlying tissue, while keeping it attached at one end to maintain blood supply, and then repositioning it to cover a nearby area that needs repair or reconstruction. This technique is often used in cases where there is a need to cover large wounds, burns, or areas affected by surgery or trauma.

Does CPT 15570 Need a Modifier?

For CPT code 15570, "Skin pedicle flap trunk," 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.

2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the body.

3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.

4. Modifier 52 - Reduced Services: Used when the procedure is partially reduced or eliminated at the physician's discretion.

5. 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.

6. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician.

7. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by a different physician.

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 when a related procedure is performed during the postoperative period.

9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period.

10. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.

11. Modifier 81 - Minimum Assistant Surgeon: Used 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: Used when these healthcare professionals assist in the surgery.

14. Modifier LT - Left Side: Used to specify that the procedure was performed on the left side of the body.

15. Modifier RT - Right Side: Used to specify that the procedure was performed on the right side of the body.

These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement.

CPT Code 15570 Medicare Reimbursement

The CPT code 15570, which involves a skin pedicle flap on the trunk, is reimbursed by Medicare, but the reimbursement specifics can vary.

To determine if CPT code 15570 is reimbursed under the Medicare Physician Fee Schedule (MPFS), healthcare providers should consult the MPFS database.

Additionally, it is crucial to check with the relevant Medicare Administrative Contractor (MAC) for the specific region, as MACs are responsible for processing Medicare claims and can provide detailed information on coverage and reimbursement rates.

Each MAC may have different local coverage determinations (LCDs) that can affect whether and how CPT code 15570 is reimbursed.

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