CPT code 15842 is for a surgical procedure involving a microsurgical graft to treat nerve palsy.
CPT code 15842 is used for the surgical procedure involving a microsurgical graft to repair nerve palsy. This code specifically refers to the intricate process of using a graft to restore function to a nerve that has been damaged or paralyzed, often requiring the use of a microscope to ensure precision during the surgery.
For CPT code 15842, which pertains to nerve palsy microsurgical grafting, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier 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 51 - Multiple Procedures
- This modifier is used when multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed.
3. Modifier 59 - Distinct Procedural Service
- Apply this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day. This is used to identify procedures that are not typically reported together but are appropriate under the circumstances.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Use this modifier when the same procedure is repeated by the same provider. This indicates that the procedure was performed more than once on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- This modifier is used when the same procedure is repeated by a different provider. It signifies that the procedure was performed more than once on the same day by different providers.
6. 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
- Apply this modifier when a patient requires a return to the operating room for a related procedure during the postoperative period of the initial surgery.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Use this modifier to indicate that a procedure performed during the postoperative period was unrelated to the original procedure.
8. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required for the procedure. It indicates that another surgeon assisted in the operation.
9. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier when an assistant surgeon provides minimal assistance during the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier when an assistant surgeon is necessary because a qualified resident surgeon is not available.
11. 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.
The CPT code 15842 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of fees and reimbursement rates for various CPT codes, including 15842. Additionally, it is crucial to consult with your local Medicare Administrative Contractor (MAC) to ensure that there are no regional variations or specific guidelines that might affect the reimbursement process for this particular code.
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