CPT code 15834 is used for the excision of excessive skin from the hip area, typically performed to improve contour and function.
CPT code 15834 is used to describe the surgical procedure for excising excessive skin from the hip area. This code is typically utilized when a patient has an overabundance of skin in the hip region, often due to significant weight loss or other medical conditions, and requires surgical removal to improve function or appearance.
When billing for CPT code 15834, which pertains to the excision of excessive skin in the hip area, 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 factors such as increased complexity or time.
2. Modifier 50 - Bilateral Procedure: If the procedure was performed on both hips, this modifier should be appended to indicate that the service was bilateral.
3. Modifier 51 - Multiple Procedures: If multiple procedures were performed during the same surgical session, this modifier should be used to indicate that more than one procedure was carried out.
4. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
5. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure was repeated by the same physician, this modifier should be used to indicate the repetition.
6. Modifier 77 - Repeat Procedure by Another Physician: If the procedure was repeated by a different physician, this modifier should be used.
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 if the patient needs to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 80 - Assistant Surgeon: If an assistant surgeon was necessary for the procedure, this modifier should be appended.
10. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required for the procedure.
11. 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 was not available.
12. 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. Always refer to the latest coding guidelines and payer-specific policies to confirm the correct usage of modifiers.
The CPT code 15834 is reimbursed by Medicare, but it is subject to specific guidelines and coverage criteria.
Reimbursement for this code is determined by the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services provided to Medicare beneficiaries.
Additionally, the coverage and reimbursement for CPT code 15834 may vary based on the policies of the Medicare Administrative Contractor (MAC) that services your region.
It is essential to consult the MPFS and your local MAC's guidelines to ensure compliance and proper reimbursement for this procedure.
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