CPT code 21137 is for the surgical reduction of the forehead, typically involving bone contouring to alter its shape.
CPT code 21137 is for the surgical procedure that involves the reduction of the forehead. This typically includes reshaping or contouring the forehead area to achieve a desired aesthetic or functional outcome.
For CPT code 21137 (Reduction of forehead), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. For example, if the reduction of the forehead involves additional complexity or time due to patient-specific factors.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the forehead, this modifier should be used to indicate that the procedure was bilateral.
3. Modifier 51 - Multiple Procedures: This modifier is used when multiple procedures are performed during the same surgical session. If the reduction of the forehead is performed along with other procedures, Modifier 51 should be appended.
4. Modifier 52 - Reduced Services: This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion. For instance, if the reduction of the forehead is not completed to the full extent originally planned.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. For example, if the reduction of the forehead is performed in conjunction with another procedure that is not typically performed together.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used if the same physician repeats the procedure on the same day. For instance, if an initial reduction of the forehead needs to be corrected or adjusted later in the day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used if a different physician repeats the procedure on the same day. For example, if a second surgeon needs to perform an additional reduction of the forehead.
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: This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon: This modifier is used if an assistant surgeon is required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: This modifier is used if a minimum assistant surgeon is required during the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used if an assistant surgeon is required because a qualified resident surgeon is not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: This modifier is used when these non-physician practitioners assist in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the services provided.
Medicare typically does not reimburse for CPT code 21137, which pertains to the reduction of the forehead. This procedure is generally considered cosmetic and not medically necessary, and therefore, it falls outside the scope of services covered by Medicare. As a result, there is no standard reimbursement amount provided by Medicare for this code. Healthcare providers should verify coverage specifics with Medicare or the patient's secondary insurance to confirm any exceptions or special circumstances that might apply.
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