CPT code 41821 is a medical billing code used for the excision of a gum flap during dental procedures.
CPT code 41821 is for the excision of a gum flap, which involves the surgical removal of a portion of the gum tissue. This procedure is typically performed to address issues such as gum disease or to facilitate access to underlying dental structures for further treatment. The excision helps in promoting healing and improving oral health by removing diseased or problematic tissue.
For the CPT code 41821 (Excision of gum flap), 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 session.
4. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. 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.
6. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is 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: Used when a related procedure is performed during the postoperative period of the initial procedure.
9. 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.
10. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure.
12. 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.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these professionals assist in the surgery.
Each modifier serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 41821, which involves the excision of a gum flap, is subject to reimbursement by Medicare. To determine if this specific CPT code is reimbursed, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered under Medicare Part B. Additionally, it is essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement policies for CPT code 41821.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 41821, RevFind provides unparalleled accuracy by individual payer. Schedule a demo today to see how RevFind can optimize your revenue cycle management and protect your bottom line.
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
