CPT code 15756 is a medical billing code for a free myocutaneous flap procedure involving microvascular transfer of skin and muscle tissue.
CPT code 15756 is used to describe a surgical procedure where a free myocutaneous flap, which includes both muscle and skin, is transferred to a new location on the body. This procedure involves the use of microsurgical techniques to connect the blood vessels of the flap to the blood vessels at the recipient site, ensuring that the transplanted tissue remains viable. This type of surgery is often utilized in reconstructive procedures to repair defects or injuries, providing both functional and aesthetic benefits.
For CPT code 15756 (Free myo/skin flap microvasc), 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
- Indicates that the procedure was performed on both sides of the body.
3. Modifier 51 - Multiple Procedures
- Applied 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 53 - Discontinued Procedure
- Indicates that a procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
6. 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.
7. Modifier 62 - Two Surgeons
- Indicates that two surgeons worked together as primary surgeons performing distinct parts of a single reportable procedure.
8. Modifier 66 - Surgical Team
- Used when a highly complex procedure requires the services of several physicians, often of different specialties, plus other highly skilled personnel.
9. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Indicates that a procedure or service was repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
10. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Used when a procedure or service performed by another physician or other qualified healthcare professional is repeated.
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
- Indicates an unplanned return to the operating room for a related procedure during the postoperative period.
12. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Used when an unrelated procedure or service is performed by the same physician during the postoperative period.
13. Modifier 80 - Assistant Surgeon
- Indicates that an assistant surgeon was required for the procedure.
14. Modifier 81 - Minimum Assistant Surgeon
- Used when an assistant surgeon provides minimal assistance during the procedure.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Indicates that an assistant surgeon was necessary because a qualified resident surgeon was not available.
16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Used when a physician assistant, nurse practitioner, or clinical nurse specialist assists 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 15756, which involves a free myo/skin flap microvasc, is subject to reimbursement by Medicare. To determine if this specific CPT code is reimbursed, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the reimbursement rates and coverage policies for various CPT codes. Additionally, it is essential to consult with the local Medicare Administrative Contractor (MAC) for region-specific guidelines and any potential variations in coverage. The MAC is responsible for processing Medicare claims and can provide definitive information on whether CPT code 15756 is reimbursed in your specific jurisdiction.
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