CPT code 15758 is a medical billing code for a free fascial flap procedure involving microvascular surgery.
CPT code 15758 is used to describe a surgical procedure known as a "free fascial flap with microvascular anastomosis." This involves the transplantation of a piece of fascia (a connective tissue) from one part of the body to another, where it is reconnected to blood vessels using microsurgical techniques. This procedure is often utilized in reconstructive surgeries to repair or replace damaged tissues, ensuring that the transplanted tissue receives adequate blood supply for optimal healing and function.
For CPT code 15758 (Free fascial flap with microvascular anastomosis), 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 surgery.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be appended to indicate that it was a bilateral procedure.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier should be used to indicate that more than one procedure was performed.
4. Modifier 52 - Reduced Services: If the procedure was partially reduced or eliminated at the physician's discretion, this modifier should be used to indicate that the service provided was less than usually required.
5. Modifier 53 - Discontinued Procedure: Use this modifier if the 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: This modifier is 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: If two surgeons worked together as primary surgeons performing distinct parts of the procedure, this modifier should be used.
8. Modifier 66 - Surgical Team: When a complex procedure requires the services of several physicians, often of different specialties, this modifier should be used to indicate that a surgical team was necessary.
9. Modifier 76 - Repeat Procedure by Same Physician: If the same physician repeats the procedure on the same day, this modifier should be used.
10. Modifier 77 - Repeat Procedure by Another Physician: If a different physician repeats the procedure on the same day, this modifier should be used.
11. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used when the patient returns 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: If an unrelated procedure is performed by the same physician during the postoperative period, this modifier should be used.
13. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier should be appended.
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): This modifier is used when 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 non-physician provider assists in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 15758, which refers to a free fascial flap microvascular procedure, is reimbursed by Medicare. Reimbursement for this code is determined based on the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services provided to Medicare beneficiaries. Additionally, the specific reimbursement rates and policies may vary depending on the region, as they are administered by the respective Medicare Administrative Contractor (MAC) for that area. It is essential for healthcare providers to consult the MPFS and their local MAC to understand the exact reimbursement details for CPT code 15758.
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