CPT code 15574 is used for the surgical procedure involving the transfer of a pedicled flap to the cheek, chin, mouth, neck, axilla, or groin.
CPT code 15574 is used to describe a surgical procedure involving the transfer or rearrangement of a pedicled flap, which is a section of tissue that is partially detached and moved to cover a nearby defect while maintaining its original blood supply. This specific code applies to flaps used on the forehead, cheeks, chin, mouth, neck, axilla (armpit), genitalia, hands, or feet. This procedure is often performed to repair defects resulting from trauma, surgery, or other medical conditions, ensuring that the affected area is adequately covered and can heal properly.
For CPT code 15574, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used when 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 a service or 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 of the initial procedure.
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 during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during 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 non-physician practitioners assist in surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15574 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and coverage details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates.
Additionally, it is advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing requirements that may apply to CPT code 15574. The MACs are responsible for processing Medicare claims and can provide detailed guidance on the reimbursement policies for this specific code.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can read your contracts and detect underpayments down to the CPT code level, including specific codes like 15574. Schedule a demo today to see how RevFind can help you identify and address underpayments by individual payer, maximizing your revenue and streamlining your financial operations.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
