CPT code 15771 is for grafting autologous fat via liposuction, involving 50 cc or less.
CPT code 15771 is used for the grafting of autologous fat, specifically when the amount of fat transferred is 50 cubic centimeters (cc) or less. This procedure involves harvesting fat from one part of the patient's body and then injecting it into another area to improve contour, volume, or appearance.
When using CPT code 15771, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 (Increased Procedural Services): This modifier is used when the work required to perform the procedure is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 50 (Bilateral Procedure): This modifier is used if the procedure is performed on both sides of the body during the same operative session.
3. Modifier 51 (Multiple Procedures): This modifier is used when multiple procedures are performed during the same session. It indicates that the procedure is one of several performed.
4. 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. It is used to identify procedures that are not normally reported together but are appropriate under the circumstances.
5. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used when the same procedure is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure.
6. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when the same procedure is repeated by another physician or other qualified healthcare professional subsequent to the original procedure.
7. 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 a related procedure is performed during the postoperative period of the initial procedure.
8. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 80 (Assistant Surgeon): This modifier is used when an assistant surgeon is required for the procedure.
10. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when a minimum assistant surgeon is required for the procedure.
11. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): This modifier is used when an assistant surgeon is required, and a qualified resident surgeon is not available.
12. 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 of these modifiers serves a specific purpose and should be used in accordance with the guidelines provided by the American Medical Association (AMA) and payer-specific policies. Proper use of modifiers ensures accurate billing and reimbursement for the services provided.
When determining if CPT code 15771 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by your regional Medicare Administrative Contractor (MAC). The MPFS is a comprehensive listing of the payment rates used by Medicare to reimburse physicians and other healthcare providers for services rendered. Each MAC, which administers Medicare claims for specific geographic regions, may have additional guidelines or policies that affect reimbursement.
To ascertain if CPT code 15771 is reimbursed, you should:
1. Check the MPFS: Access the latest version of the Medicare Physician Fee Schedule to see if CPT code 15771 is listed and to review the associated reimbursement rate.
2. Consult Your MAC: Verify with your regional Medicare Administrative Contractor for any specific coverage policies or additional documentation requirements that may impact reimbursement for CPT code 15771.
By following these steps, you can determine whether CPT code 15771 is eligible for reimbursement under Medicare.
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