CPT code 00834 is used for anesthesia services provided during hernia repair surgery for patients under 1 year old.
CPT code 00834 is used to describe the anesthesia services provided for a hernia repair procedure in patients who are less than one year old. This code is specifically designated for the administration of anesthesia during the surgical repair of a hernia in infants, ensuring that the unique physiological considerations and requirements of this age group are met during the procedure.
When dealing with CPT code 00834, which pertains to anesthesia for hernia repair in patients under 1 year of age, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide a service is substantially greater than typically required. For instance, if the hernia repair procedure is more complex due to the patient's condition, this modifier may be appropriate.
2. Modifier 23 - Unusual Anesthesia: This is applicable when a procedure that usually requires no anesthesia or local anesthesia must be performed under general anesthesia due to unusual circumstances.
3. Modifier 47 - Anesthesia by Surgeon: If the surgeon administers the anesthesia, this modifier is used to indicate that the anesthesia was provided by the surgeon rather than an anesthesiologist.
4. 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. It may be necessary if multiple procedures are performed and need to be billed separately.
5. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the procedure on the same day, this modifier is used to indicate that the repeat procedure was necessary.
6. Modifier 77 - Repeat Procedure by Another Physician: This is used when a procedure is repeated by a different physician on the same day.
7. 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.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This is used when a procedure is performed during the postoperative period of another procedure, but the two are unrelated.
9. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier is used to indicate that multiple modifiers apply.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines set forth by the American Medical Association and payer policies to ensure accurate billing and reimbursement.
CPT code 00834 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates. However, the actual reimbursement for CPT code 00834 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC has the authority to interpret national Medicare policies and set local coverage determinations, which can influence whether and how much Medicare reimburses for this specific code. Therefore, healthcare providers should consult their local MAC for precise reimbursement details and any additional requirements that may apply.
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