CPT CODES

CPT Code 41135

CPT code 41135 is for tongue and neck surgery, detailing specific procedures for healthcare providers in billing and documentation.

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What is CPT Code 41135

CPT code 41135 is for a surgical procedure involving the tongue and neck. This code specifically refers to the excision of a lesion or abnormal tissue from the tongue or neck area, which may include the removal of tumors or other growths. The procedure is typically performed to address conditions that could affect the patient's oral or neck health, and it may involve various techniques depending on the size and location of the lesion.

Does CPT 41135 Need a Modifier?

For CPT code 41135 (Tongue and neck surgery), 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 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the body.

3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.

4. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.

5. Modifier 53 - Discontinued Procedure: Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

6. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.

7. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a procedure.

8. Modifier 66 - Surgical Team: Used when a highly complex procedure is carried out by a surgical team.

9. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician repeats a procedure or service subsequent to the original procedure.

10. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service performed by another physician is repeated.

11. 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.

12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period.

13. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.

14. Modifier 81 - Minimum Assistant Surgeon: Used when an assistant surgeon is required for a minimal portion of the procedure.

15. 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.

16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in surgery.

Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.

CPT Code 41135 Medicare Reimbursement

The CPT code 41135 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 corresponding reimbursement rates.

Additionally, it is crucial to consult with your local Medicare Administrative Contractor (MAC) to ensure that there are no regional variations or specific requirements that might affect reimbursement for CPT code 41135. Each MAC may have unique guidelines and policies that could impact the reimbursement process.

Are You Being Underpaid for 41135 CPT Code?

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