CPT code 15740 is for an island pedicle flap graft, a surgical procedure used to transfer skin and tissue to a different area of the body.
CPT code 15740 is used to describe a surgical procedure known as an "island pedicle flap graft." This procedure involves taking a section of tissue, including skin and underlying structures, from one part of the body and moving it to another area that needs repair or reconstruction. The "island" refers to the piece of tissue being moved, and the "pedicle" indicates that this tissue remains attached to its original blood supply, ensuring it stays viable during and after the transfer. This technique is often used in reconstructive surgeries to repair defects or wounds.
For CPT code 15740 (Island pedicle flap graft), 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 graft.
2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the island pedicle flap graft is performed on both sides of the body during the same operative session.
3. Modifier 51 - Multiple Procedures
- Use this modifier when multiple procedures, including the island pedicle flap graft, are performed during the same surgical session.
4. Modifier 52 - Reduced Services
- This modifier is appropriate if the procedure was 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
- Apply this modifier if the island pedicle flap graft is part of a staged or related procedure during the postoperative period of the initial surgery.
6. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the island pedicle flap graft was a distinct procedural service from other services performed on the same day.
7. Modifier 62 - Two Surgeons
- This modifier is used when two surgeons work together as primary surgeons performing distinct parts of the procedure.
8. Modifier 66 - Surgical Team
- Apply this modifier if the procedure requires the expertise of a surgical team.
9. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Use this modifier if the island pedicle flap graft is repeated by the same physician or healthcare professional.
10. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- This modifier is appropriate if the procedure is repeated by a different physician or healthcare professional.
11. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional 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.
12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery.
13. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required for the procedure.
14. Modifier 81 - Minimum Assistant Surgeon
- Use this modifier if a minimum assistant surgeon is required for the procedure.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier if an assistant surgeon is necessary because a qualified resident surgeon is not available.
16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
Each modifier serves a specific purpose and should be used accurately to ensure proper billing and reimbursement.
The CPT code 15740, which refers to an island pedicle flap graft, is reimbursed by Medicare. To determine the reimbursement specifics, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B. Additionally, it is essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they are responsible for processing Medicare claims and can provide detailed information on coverage policies and any potential local coverage determinations (LCDs) that may affect reimbursement for CPT code 15740.
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