CPT code 41872 is used for the surgical repair of gum tissue, helping healthcare providers accurately bill for this specific dental procedure.
CPT code 41872 is used to describe the surgical procedure for the repair of the gums, specifically addressing issues such as gum recession or defects. This code indicates that a healthcare provider has performed a surgical intervention to restore the integrity and function of the gum tissue, which may involve techniques such as grafting or suturing to enhance the overall health of the periodontal area.
For CPT code 41872 (Repair gum), 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 59 - Distinct Procedural Service: Used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: Used when a procedure or service is repeated by the same provider.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Used when a procedure or service is repeated by a different provider.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Indicates an unplanned return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same provider during the postoperative period of the initial procedure.
8. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was required during the procedure.
9. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was necessary because a qualified resident surgeon was not available.
11. 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 41872 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates 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 important to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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