CPT Code 40525
CPT code 40525 is a medical billing code used for reconstructing the lip using a flap technique in surgical procedures.
Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.
What is CPT Code 40525
CPT code 40525 is a procedure for reconstructing the lip using a flap technique, which involves transferring tissue from one area to repair and reshape the lip.
Does CPT 40525 Need a Modifier?
Modifiers that could be used with this CPT code:
1. -50: Bilateral procedure
2. -51: Multiple procedures
3. -52: Reduced services
4. -58: Staged or related procedure or service by the same physician during the postoperative period
5. -59: Distinct procedural service
6. -76: Repeat procedure or service by same physician
7. -77: Repeat procedure or service by another physician
8. -78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period
9. -79: Unrelated procedure or service by the same physician during the postoperative period
10. -RT: Right side
11. -LT: Left side
CPT Code 40525 Medicare Reimbursement
CPT code 40525 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's essential to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
Are You Being Underpaid for 40525 CPT Code?
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 40525. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and maximize your revenue.
Get paid in full by bringing clarity to your revenue cycle
Related CPT Codes
CPT Code 11971
CPT code 11971 is for the removal of tissue expander without insertion of an implant.
CPT Code 12041
CPT code 12041 is for intermediate repair of non-hf/genital wounds 2.5 cm or less.
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
