CPT code 01464 is used to identify anesthesia services provided during ankle or foot arthroscopy procedures.
CPT code 01464 is used to describe the anesthesia services provided for a surgical procedure involving arthroscopy of the ankle or foot. Arthroscopy is a minimally invasive surgical technique that involves inserting a small camera and instruments into the joint to diagnose or treat conditions. This specific code is utilized by anesthesiologists or anesthesia providers to bill for their professional services during such procedures, ensuring that the patient remains comfortable and pain-free throughout the surgery.
For CPT code 01464, which pertains to anesthesia for ankle or foot arthroscopy, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the anesthesia service provided was significantly greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 23 (Unusual Anesthesia): This modifier 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 regional or general anesthesia, this modifier is used to indicate that the anesthesia service was provided by the surgeon.
4. Modifier 59 (Distinct Procedural Service): Use this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day. This may be necessary if multiple procedures are performed and need to be reported separately.
5. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used when the same procedure is repeated by the same physician. It indicates that the procedure was repeated on the same day.
6. Modifier 77 (Repeat Procedure by Another Physician): Similar to Modifier 76, but used when the repeat procedure is performed by a different physician.
7. Modifier 78 (Unplanned Return to the Operating/Procedure Room): This modifier is used when a patient returns 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): Use this modifier when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier AA (Anesthesia Services Performed Personally by Anesthesiologist): This modifier is used to indicate that the anesthesia services were personally performed by an anesthesiologist.
10. Modifier QK (Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures): This modifier is used when an anesthesiologist is medically directing two to four concurrent anesthesia procedures.
11. Modifier QS (Monitored Anesthesia Care Service): Indicates that monitored anesthesia care was provided.
12. Modifier QX (CRNA Service with Medical Direction by a Physician): This modifier is used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.
13. Modifier QY (Medical Direction of One CRNA by an Anesthesiologist): Indicates that an anesthesiologist is providing medical direction for one CRNA.
14. Modifier QZ (CRNA Service without Medical Direction by a Physician): This modifier is used when a CRNA provides anesthesia services without the medical direction of a physician.
These modifiers help provide additional information about the circumstances under which the anesthesia service was provided, ensuring accurate billing and reimbursement. Always ensure that documentation supports the use of any modifier applied.
CPT code 01464, which pertains to a specific medical procedure, is subject to reimbursement considerations under Medicare. To determine if this code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered by Medicare, including whether a particular CPT code is reimbursable and at what rate.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide region-specific guidance on coverage and reimbursement policies. They may have local coverage determinations (LCDs) that affect whether CPT code 01464 is reimbursed in a particular area.
Healthcare providers should consult both the MPFS and their respective MAC to confirm the reimbursement status of CPT code 01464, as policies and rates can vary based on geographic location and other factors.
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