CPT code 01484 is used for anesthesia services during a surgical procedure involving the revision of the lower leg.
CPT code 01484 is used to describe anesthesia services provided for a surgical procedure involving the revision of the lower leg. This code is specifically designated for anesthesia administration during surgeries that require modification or correction of previous surgical work on the lower leg, which may include procedures on bones, muscles, or other tissues. The use of this code ensures that the anesthesia services are accurately documented and billed, reflecting the complexity and specific nature of the surgical intervention on the lower extremity.
For CPT code 01484, which pertains to anesthesia for procedures on the lower leg, there are several modifiers that may be applicable. These modifiers are used to provide additional information about the procedure and ensure accurate billing and reimbursement. Here is a list of potential modifiers that could be used with this code:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide the service is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 23 - Unusual Anesthesia: This is used 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: This modifier is used when the surgeon administers regional or general anesthesia to the patient. It is not used for local anesthesia.
4. Modifier 59 - Distinct Procedural Service: This modifier indicates that a procedure or service was distinct or independent from other services performed on the same day. It is used to identify procedures that are not normally reported together but are appropriate under the circumstances.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
6. Modifier 77 - Repeat Procedure by Another Physician: This is used when a procedure or service is repeated by another physician or qualified healthcare professional subsequent to the original procedure or service.
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 when a patient requires a 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 or service performed during the postoperative period was unrelated to the original procedure.
9. Modifier 99 - Multiple Modifiers: This is used when two or more modifiers are necessary to describe the service provided.
These modifiers help in providing a more comprehensive picture of the services rendered and ensure that the billing accurately reflects the complexity and circumstances of the procedure. Proper use of modifiers is crucial for compliance and optimal reimbursement in healthcare revenue cycle management.
The CPT code 01484 is associated with anesthesia services for lower leg revision procedures. To determine if this specific CPT code is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with their respective reimbursement rates.
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 a particular CPT code, such as 01484, is reimbursed in a specific geographic area.
Therefore, to ascertain if CPT code 01484 is reimbursed by Medicare, healthcare providers should review the MPFS for the current year and consult with their respective MACs to ensure compliance with any local policies or requirements.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 01484, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and enhance your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
