CPT code 15576 is for a pedicle flap procedure involving the ear, nose, eyelid, or intraoral areas, used in reconstructive surgeries.
CPT code 15576 is used to describe a surgical procedure involving the transfer of a pedicle flap, which is a section of tissue that is partially detached and moved to a new location while maintaining its original blood supply. This specific code pertains to the transfer of a pedicle flap in the ear, nose, eyelid, or intraoral (inside the mouth) regions. This procedure is typically performed to repair defects or injuries in these areas, ensuring that the tissue remains viable and promotes healing.
For CPT code 15576, 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: Apply this modifier if the procedure was performed on both sides of the body during the same session.
3. Modifier 51 - Multiple Procedures: Use this modifier when multiple procedures are performed during the same surgical session. This helps indicate that the procedure is one of several performed.
4. Modifier 52 - Reduced Services: This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service: Apply this modifier to indicate that the procedure is distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same procedure is repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day.
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: Use this modifier 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: Apply this modifier when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon: Use this modifier if an assistant surgeon was required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when an assistant surgeon provides minimal assistance during the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Apply this modifier when an assistant surgeon is used because a qualified resident surgeon was not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Use this modifier when a non-physician provider assists in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 15576 is subject to reimbursement by Medicare, but its coverage and payment amount are determined by the Medicare Physician Fee Schedule (MPFS). To ascertain if CPT code 15576 is reimbursed and the specific reimbursement rate, healthcare providers should consult the MPFS. Additionally, it is essential to verify with the local Medicare Administrative Contractor (MAC), as they administer Medicare claims and can provide detailed information on coverage policies and any potential regional variations.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 15576, and by individual payer. Don't leave money on the table—schedule a demo today to see how RevFind can optimize your revenue cycle management.
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
