CPT code 40525 is a medical billing code used for reconstructing the lip using a flap technique in surgical procedures.
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.
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 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.
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
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
