CPT code 15847 is for excision of excess skin in the abdomen, used as an add-on procedure in medical billing and coding.
CPT code 15847 is used to describe an additional surgical procedure that involves the excision of excess skin and subcutaneous tissue from the abdomen. This code is typically used as an add-on to a primary procedure, indicating that the surgeon performed extra work to remove more skin and tissue than what was initially planned. This is often necessary in cases where significant weight loss or other factors have resulted in an excess of loose skin that needs to be addressed for both functional and aesthetic reasons.
Certainly! Here are the modifiers that could be used with CPT code 15847:
1. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 51 - Multiple Procedures
- Applied when multiple procedures are performed during the same surgical session.
3. Modifier 59 - Distinct Procedural Service
- Indicates that a procedure or service was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician
- Used when a procedure or service is repeated by the same physician or other qualified healthcare professional.
5. Modifier 77 - Repeat Procedure by Another Physician
- Applied when a procedure or service is repeated by another physician or other qualified healthcare professional.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- Used when a related procedure is performed during the postoperative period of the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that an unrelated procedure or service was performed by the same physician during the postoperative period.
8. Modifier 80 - Assistant Surgeon
- Applied when an assistant surgeon is required during the procedure.
9. Modifier 81 - Minimum Assistant Surgeon
- Used when a minimum assistant surgeon is required during the procedure.
10. 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.
11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery
- Applied when a non-physician provider assists in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
When considering whether CPT code 15847 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by your Medicare Administrative Contractor (MAC). The MPFS is a comprehensive listing of the maximum fees Medicare will pay for various services, and it is updated annually.
CPT code 15847, which is an add-on code, may have specific reimbursement criteria. Add-on codes are typically reimbursed only when reported in conjunction with a primary procedure code. Therefore, to determine if CPT code 15847 is reimbursed by Medicare, you should:
1. Check the MPFS: Verify if CPT code 15847 is listed and whether it has an assigned fee schedule amount.
2. Consult Your MAC: Each MAC may have specific local coverage determinations (LCDs) or guidelines that affect reimbursement. Your MAC can provide detailed information on whether CPT code 15847 is covered and under what circumstances.
By following these steps, you can ascertain whether Medicare will reimburse CPT code 15847 for your specific situation.
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