CPT code 15944 is a medical code used to document the surgical removal of a hip pressure sore.
CPT code 15944 is used for the surgical procedure to remove a pressure sore (also known as a decubitus ulcer) located on the hip. This code specifically refers to the excision of the sore, which involves removing the damaged tissue to promote healing and prevent further complications. This procedure is often necessary for patients who have developed pressure sores due to prolonged immobility or other underlying health conditions.
When using CPT code 15944 for the removal of a hip pressure sore, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers and the reasons for their use:
1. Modifier 22 (Increased Procedural Services):
- Use this modifier if the procedure required significantly greater effort or complexity than typically required.
2. Modifier 50 (Bilateral Procedure):
- Apply this modifier if the procedure was performed on both hips during the same surgical session.
3. Modifier 51 (Multiple Procedures):
- Use this modifier when multiple procedures are performed during the same surgical session.
4. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period):
- This modifier is used if the procedure was planned or anticipated (staged) or more extensive than the original procedure.
5. Modifier 59 (Distinct Procedural Service):
- Apply this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
6. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional):
- Use this modifier if the same procedure was repeated by the same physician.
7. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional):
- Apply this modifier if the procedure was repeated by a different physician.
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):
- This modifier is used if the patient required 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):
- Use this modifier if the procedure was unrelated to the original surgery and performed during the postoperative period.
10. Modifier 80 (Assistant Surgeon):
- Apply this modifier if an assistant surgeon was necessary for the procedure.
11. Modifier 81 (Minimum Assistant Surgeon):
- Use this modifier if a minimum assistant surgeon was required.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)):
- This modifier is used when an assistant surgeon is required because a qualified resident surgeon was not available.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery):
- Apply this modifier if a non-physician provider assisted in the surgery.
Each of these modifiers serves a specific purpose and should be used accurately to ensure proper billing and reimbursement. Always refer to the latest CPT and payer guidelines to confirm the appropriate use of modifiers.
The CPT code 15944 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 services covered by Medicare and their respective reimbursement rates. Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and guidelines. Therefore, healthcare providers should consult their respective MAC for precise information on the reimbursement rates and any specific requirements for CPT code 15944.
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