Do you bill for CPT 65778 in your practice? Keep reading.
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Definition: The amniotic membrane comprises the innermost layer of the placenta. Amniotic membrane transplantation (AMT) has been used in many different types of reconstructive surgery.⁣
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There is no global period for CPT 65778.⁣⁣ Reimbursement is signifcantly less if done in the ASC because the ASC pays for the cost of the amniotic membrane. Billing guidelines from CMS.GOV can be found here. Reimbursement statistics from Corcoran Consulting Group show Medicare reimbursed physicans $1,448 in 2018 for in office procedures.

Use modifier -25 if a significant, separate E/M service was done on the same day as the procedure.  Make sure the criteria for modifier -25 has been met if you’re billing for an exam. You don’t want to be an outlier and get audited.  Everything you need to know about modifier -25 is here.

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