Forum - Questions & Answers

Sep 10th, 2012 - anil 6 

Need modifier

Hello, I received denial from MCR for procedures 15340, G0440, 15341 and used diagnosis 707.14. Denied reason " the procedure code is inconsisten with the modifer used or a required modifier is missing". so we tried with modifier 51 for procedure G0440, 15340 mod 59, 15341 mod 59, but again we get denied as above reason. Cany any help would be greatly apprectiated thank you..............

Sep 10th, 2012 - rhorton4 22 

re: NEED MODIFIER

These are expired codes see below

Code 15340
Description Tissue cultured allogeneic skin substitute; first 25 sq cm or less
Effective Date 01/01/2006
Expiration Date 12/31/2011
Revised Date
Replacement Codes 15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278
See Also

Official Notes Do not report 15340, 15341 inconjunction with 11042, 15002-15005

MedAssets Notes Per 2012 OPPS Final Rule replacement codes are 15271 or 15275.
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Code 15341
Description Tissue cultured allogeneic skin substitute; each additional 25 sq cm, or part thereof (List separately in addition to code for primary procedure)
Effective Date 01/01/2006
Expiration Date 12/31/2011
Revised Date 01/01/2009
Replacement Codes 15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278
See Also

Revision History
2 revisions available, current revision is shown in bold. Start Date End Date Description
01/01/2009 12/31/2011 Tissue cultured allogeneic skin substitute; each additional 25 sq cm, or part thereof (List separately in addition to code for primary procedure)
01/01/2006 12/31/2008 Tissue cultured allogeneic skin substitute; each additional 25 sq cm

Official Notes CPT® Add-on Code Use 15341 in conjunction with 15340
Do not report 15340, 15341 in conjunction with 11042, 15002-15005 (2011)

MedAssets Notes Per 2012 OPPS Final Rule replacement codes are 15272 and 15276.
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Code G0440
Description Application of tissue cultured allogeneic skin substitute or dermal substitute; for use on lower limb, includes the site preparation and debridement if performed; first 25 sq cm or less
Effective Date 01/01/2011
Expiration Date 12/31/2011
Revised Date
Replacement Codes
See Also



Sep 12th, 2012 - anil 6 

re: NEED MODIFIER

THANK YOU FOR YOUR RESPOND

We have billed in 11/08/2011,11/22/2011 and 12/06/2011 we get the denial from mcr reason above mentioned. please what do you want me to do ?



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