CPT code 15777 is used for billing acellular dermal matrix implant procedures in medical settings.
CPT code 15777 is used for the implantation of an acellular dermal matrix. This procedure involves placing a biologically derived material, which lacks cellular components, into the body to support tissue regeneration and healing. The acellular dermal matrix acts as a scaffold, promoting the growth of new, healthy tissue in areas where it is needed, such as in reconstructive surgeries or wound repair.
For CPT code 15777 (Acellular derm matrix implant), 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. This could be due to complications or other factors that increase the complexity of the procedure.
2. Modifier 50 - Bilateral Procedure
- Applied when the procedure is performed on both sides of the body during the same operative session.
3. Modifier 51 - Multiple Procedures
- Used when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
4. Modifier 59 - Distinct Procedural Service
- Indicates that the procedure is distinct or independent from other services performed on the same day. This could be due to different sessions, different procedures, or different sites.
5. Modifier 62 - Two Surgeons
- Used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
6. Modifier 76 - Repeat Procedure by Same Physician
- Applied when the same physician performs the procedure more than once on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician
- Used when a procedure is repeated by another 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
- Indicates an unplanned 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
- Used when a procedure or service performed during the postoperative period is unrelated to the original procedure.
10. Modifier 80 - Assistant Surgeon
- Applied when an assistant surgeon is required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Used when an assistant surgeon provides minimal assistance during the procedure.
12. 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.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Used when a non-physician practitioner 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 15777 is reimbursed by Medicare, but its reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). Additionally, the final determination of coverage and reimbursement for CPT code 15777 may vary depending on the policies of the local Medicare Administrative Contractor (MAC). It is essential for healthcare providers to consult the MPFS and their respective MAC for the most accurate and up-to-date information regarding the reimbursement criteria for this code.
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