Forum - Questions & Answers

May 30th, 2018 - gowri.tina

DERMATOLOGY - Muscle, myocutaneous, or fasciocutaneous flap; CPT 15733

Cpt 15733 - Muscle, myocutaneous, or fasciocutaneous flap; is a reconstructive procedure which was done in place of service - office but GHI denies this procedure as invalid place of service.

Could anyone help me out. Can cpt 15733 can be performed in office visit(pos)

Jun 13th, 2018 - ChrisW   256  1 

Understanding Payment and Status Indicators

Look at the payment indicator "A2" this means the procedure 15733, is a surgical procedure on the ASC list and payment is based on the hospital outpatient rate. In other words, the "A2" status indicator for this procedure should be billed in a facility as the procedure code is an ASC code (Ambulatory Surgery Center). It is paid under OPPS with a separate APC payment.

Be sure to look at the payment indicators, we are seeing a lot of denials due to the fact important information on a code is not being considered. If you have a Find-A-Code account look under the "Additional Code Information" on any code page to see applicable indicators and the description of how they are used.

Understanding payment and status indicators is an important aspect of CPT codes. In addition, 15733 is considered a Cosmetic and Reconstructive Procedure for some payers, be sure to verify if it is a covered benefit for the service provided.

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