CPT code 40840 is a medical billing code used for the reconstruction of the mouth, helping healthcare providers accurately document and bill for services.
CPT code 40840 is for the surgical procedure involving the reconstruction of the mouth. This code is used when a healthcare provider performs a surgical intervention to repair or reconstruct the oral cavity, which may be necessary due to trauma, congenital defects, or disease. The procedure aims to restore function and aesthetics to the mouth, ensuring that the patient can eat, speak, and maintain oral hygiene effectively.
For CPT code 40840, "Reconstruction of mouth," the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 52 - Reduced Services: Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.
3. Modifier 53 - Discontinued Procedure: Used when a procedure is terminated due to extenuating circumstances or those that threaten the well-being of the patient.
4. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure.
6. Modifier 66 - Surgical Team: When a team of surgeons is required to perform the procedure.
7. Modifier 76 - Repeat Procedure or Service by Same Physician: Indicates that a procedure or service was repeated by the same physician subsequent to the original procedure or service.
8. Modifier 77 - Repeat Procedure by Another Physician: Indicates that a procedure or service was repeated by another physician subsequent to the original procedure or service.
9. 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.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Indicates that the performance of a procedure or service during the postoperative period was unrelated to the original procedure.
11. Modifier 80 - Assistant Surgeon: When an assistant surgeon is required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: When a minimum assistant surgeon is required during the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required, and a qualified resident surgeon is not available.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Indicates that a non-physician provider assisted in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 40840 is reimbursed by Medicare. The reimbursement rate for this code can be found in the Medicare Physician Fee Schedule (MPFS). Healthcare providers should consult their local Medicare Administrative Contractor (MAC) for specific coverage guidelines and payment rates, as these may vary by region.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 40840. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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
